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Three-dimensional analysis of choroidal vessels in eyes with Vogt-Koyanagi-Harada disease before and after treatment

Published:August 21, 2020DOI:https://doi.org/10.1016/j.jcjo.2020.06.016

      Abstract

      Objective

      To investigate a 3-dimensional analysis of choroidal vessels using binarization of ultrawide-field indocyanine green angiography (UWFICGA) images and swept-source optical coherence tomography (SS-OCT) images before and after treatment in eyes with Vogt-Koyanagi-Harada (VKH) disease.

      Methods

      Seven eyes of 7 patients (2 men and 5 women; mean age, 48.3 years) with VKH disease and 8 control eyes of 8 patients (4 men and 4 women; mean age, 47.6 years) who visited from August 1, 2015, through July 31, 2017, were enrolled. UWF fluorescein angiography images were subtracted from UWFICGA images in all patients to evaluate the choroidal vessel densities. A vertical analysis of the choroid also was performed in the same way with SS-OCT images.

      Results

      At the acute stage of VKH disease, the mean choroidal vascular densities in both posterior and mid-peripheral areas were significantly (p < 0.01) lower than in control eyes, and recovered after the treatment. In addition, the choroidal stroma significantly (p < 0.01) decreased after the treatment and the choroidal lumina significantly (p < 0.01) increased.

      Conclusions

      Current results suggest that diffuse cellular infiltration into the choroidal stroma might compress choroidal vessels and the change would resolve after treatment.

      Résumé

      Objectif

      Évaluer l'intérêt d'une analyse tridimensionnelle des vaisseaux choroïdiens à l'aide de la binarisation des images obtenues à l'angiographie ultra-grand champ au vert d'indocyanine (UWFICGA, pour ultrawide-field indocyanine green angiography) et à la tomographie par cohérence optique de source à balayage (SS-OCT, pour swept-source optical coherence tomography) avant et après le traitement de la maladie de Vogt-Koyanagi-Harada (VKH).

      Méthodes

      Sept yeux de 7 patients (2 hommes et 5 femmes; âge moyen : 48,3 ans) qui présentaient une maladie de VKH et 8 yeux témoins de 8 patients (4 hommes et 4 femmes; âge moyen : 47,6 ans) qui ont consulté entre le 1er août 2015 et le 31 juillet 2017 ont pris part à cette étude. Les images obtenues à l'angiographie ultra-grand champ à la fluorescéine ont été soustraites des images UWFICGA chez tous les patients afin d’évaluer la densité des vaisseaux choroïdiens. Une analyse verticale de la choroïde a également été réalisée de la même façon à partir des images obtenues à la SS-OCT.

      Résultats

      Pendant la phase aiguë de la maladie de VKH, la densité vasculaire choroïdienne moyenne mesurée dans les zones postérieure et mi-périphérique était significativement (p < 0,01) moindre que dans les yeux témoins, et ce paramètre s'est rétabli après le traitement. De plus, le stroma choroïdien a diminué significativement (p < 0,01) après le traitement, tandis que l'on a observé une augmentation significative (p < 0,01) de la lamina de la choroïde.

      Conclusions

      Si l'on se fie aux résultats à ce jour, il est possible que l'infiltration cellulaire diffuse dans le stroma choroïdien exerce une pression sur les vaisseaux choroïdiens, phénomène qui disparaîtrait après le traitement.
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