Publications by authors named "Kotaro Tsuboi"

17 Publications

  • Page 1 of 1

Comparison of Central Macular Fluid Volume With Central Subfield Thickness in Patients With Diabetic Macular Edema Using Optical Coherence Tomography Angiography.

JAMA Ophthalmol 2021 May 13. Epub 2021 May 13.

Casey Eye Institute, Oregon Health & Science University, Portland.

Importance: Diabetic macular edema (DME) is the predominant cause of visual impairment in patients with type 1 or 2 diabetes. Automated fluid volume measurements using optical coherence tomography (OCT) may improve the diagnostic accuracy of DME screening.

Objective: To assess the diagnostic accuracy of an automated central macular fluid volume (CMFV) quantification using OCT for DME.

Design, Setting, And Participants: A cross-sectional observational study was conducted at a tertiary academic center among 215 patients with diabetes (1 eye each) enrolled from January 26, 2015, to December 23, 2019. All participants underwent comprehensive examinations, 6 × 6-mm macular structural OCT horizontal raster scans, and 6 × 6-mm macular OCT angiography volumetric scans. From January 1 to March 30, 2020, 2 retinal specialists reviewed the structural OCT scans independently and diagnosed DME if intraretinal or subretinal fluid was present. Diabetic macular edema was considered center involved if fluid was present within the central fovea (central 1-mm circle). A third retinal specialist arbitrated any discrepancy. The mean central subfield thickness (CST) within the central fovea was measured on structural OCT horizontal raster scans. A deep learning algorithm automatically quantified fluid volumes on 6 × 6-mm OCT angiography volumetric scans and within the central foveas (CMFV).

Main Outcomes And Measures: The area under the receiver operating characteristic curve (AUROC) and the sensitivity and specificity of CST and CMFV for DME diagnosis.

Results: We enrolled 1 eye each of 215 patients with diabetes (117 women [54.4%]; mean [SD] age, 59.6 [12.4] years). Diabetic macular edema was present in 136 eyes; 93 cases of DME were center involved. The AUROC of CMFV for diagnosis of center-involved DME (0.907 [95% CI, 0.861-0.954]) was greater than the AUROC of CST (0.832 [95% CI, 0.775-0.889]; P = .02). With the specificity set at 95%, the sensitivity of CMFV for detection of center-involved DME (78.5% [95% CI, 68.8%-86.3%]) was higher than that of CST (53.8% [95% CI, 43.1%-64.2%]; P = .002). Center-involved DME cases not detected by CST but detected by CMFV were associated with a thinner CST (290.8 μm [95% CI, 282.3-299.3 μm] vs 369.4 μm [95% CI, 347.1-391.7 μm]; P < .001), higher proportion of previous macular laser treatment (11 of 28 [39.3%; 95% CI, 21.5%-59.4%] vs 12 of 65 [18.5%; 95% CI, 9.9%-30.0%]; P = .03), and female sex (20 of 28 [71.4%; 95% CI, 51.3%-86.8%] vs 31 of 65 [47.7%; 95% CI, 35.1%-60.5%]; P = .04).

Conclusions And Relevance: These findings suggest that an automated CMFV is a more accurate diagnostic biomarker than CST for DME and may improve screening for DME.
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http://dx.doi.org/10.1001/jamaophthalmol.2021.1275DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8120439PMC
May 2021

Optimal Display Positions for Heads-Up Surgery to Minimize Crosstalk.

Transl Vis Sci Technol 2020 12 17;9(13):28. Epub 2020 Dec 17.

Department of Ophthalmology, Aichi Medical University, Nagakute, Japan.

Purpose: To determine optimal display positions during heads-up surgery (HUS) to minimize crosstalk.

Methods: Three three-dimensional (3D) displays were analyzed to evaluate the relationship between display position and amount of crosstalk. First, the 3D displays were calibrated to show a completely white image in the right eye and completely black image in the left eye. Images were captured through the polarized filter, which corresponded to the left-eye image. The amount of crosstalk in the left eye was measured as white areas on the black background that originated from the right-eye image. The amount of crosstalk was measured at different display distances and heights to estimate the non-crosstalk display positions for each display.

Results: Varying amounts of crosstalk (0%-70.3%) were observed for different display distances and heights. The crosstalk almost always started from the corner of the display, although the starting area varied according to the type of display. The minimum distance of non-crosstalk position was 1.26 meters away from display 1, 1.24 meters away from display 2, and 1.8 meters away from display 3. With regard to display height, the optimal center-of-display heights for displays 1, 2, and 3 were 72 mm below, 18 mm above, and 101 mm above eye level, respectively.

Conclusions: The amount of crosstalk differed according to display positions and displays.

Translational Relevance: The optimal HUS display settings differ among displays; therefore, each surgeon should carefully evaluate individual display characteristics before using HUS in practice.
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http://dx.doi.org/10.1167/tvst.9.13.28DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746959PMC
December 2020

Alterations of retinal thickness measured by optical coherence tomography correlate with neurophysiological measures in diabetic polyneuropathy.

J Diabetes Investig 2020 Dec 10. Epub 2020 Dec 10.

Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan.

Aims/introduction: Diabetic polyneuropathy (DPN) and diabetic retinopathy (DR) are traditionally regarded as microvascular complications. However, these complications may share similar neurodegenerative pathologies. Here we evaluate the correlations in the severity of DPN and changes in the thickness of neuroretinal layers to elucidate whether these complications exist at similar stages of progression.

Materials And Methods: A total of 43 patients with type 2 diabetes underwent a nerve conduction study (NCS), a macular optical coherence tomography, and a carotid artery ultrasound scan. Diabetic polyneuropathy was classified according to Baba's classification using NCS. The retina was automatically segmented into four layers; ganglion cell complex (GCC), inner nuclear layer/outer plexiform layer (INL/OPL), outer nuclear layer/photoreceptor inner and outer segments, and retinal pigment epithelium (RPE). The thickness of each retinal layer was separately analyzed for the fovea and the parafovea.

Results: Fourteen patients were classified as having moderate to severe diabetic polyneuropathy. The thicknesses of the foveal and parafoveal INL/OPL increased in patients with diabetic polyneuropathy compared with patients without. The thickness of the parafoveal retinal pigment epithelium decreased in patients with diabetic polyneuropathy. The thinning of parafoveal ganglion cell complex and foveal and parafoveal retinal pigment epithelium were positively correlated with deterioration of nerve functions in the nerve conduction study, but the thickening of INL/OPL was positively correlated with the nerve function deterioration. The thinning of parafoveal ganglion cell complex and foveal retinal pigment epithelium were positively correlated with the thickening of the carotid intima-media.

Conclusions: Depending on the progression of diabetic polyneuropathy, the ganglion cell complex and retinal pigment epithelium became thinner and the INL/OPL became thicker. These retinal changes might be noteworthy for pathological investigations and for the assessment of diabetic polyneuropathy and diabetic retinopathy.
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http://dx.doi.org/10.1111/jdi.13476DOI Listing
December 2020

Visual Acuity Recovery After Macular Hole Closure Associated With Foveal Avascular Zone Change.

Transl Vis Sci Technol 2020 07 14;9(8):20. Epub 2020 Jul 14.

Department of Ophthalmology, Aichi Medical University, Nagakute, Japan.

Purpose: To evaluate changes in the foveal avascular zone (FAZ) area during the postoperative period of macular hole (MH) surgery using the optical coherence tomography angiography (OCTA) and to investigate its relationship to visual acuity (VA).

Methods: Consecutive unilateral MH patients who underwent successful MH closure with at least a six-month observation period were studied retrospectively. To evaluate the FAZ area, OCTA images were obtained at the preoperative visit, the first postoperative visit, and the six-month visit. Main outcome measures were postoperative FAZ change and its relationship to VA change after MH closure.

Results: Fifty-one cases were studied. The FAZ area was 0.42 ± 0.11 mm at the preoperative visit, 0.25 ± 0.091 mm at the first postoperative visit and 0.31 ± 0.11 mm at the six-month visit. FAZ area at the first postoperative visit was significantly smaller ( < 0.0001) than at the preoperative visit. FAZ area at the six-month visit was significantly greater ( < 0.0001) than at the first postoperative visit, but still significantly smaller ( = 0.0002) compared to the normal fellow eye. The postoperative FAZ area enlargement from the first postoperative visit to the six-month visit was significantly correlated with the postoperative VA recovery ( = 0.0322) and the postoperative photoreceptor reconstruction ( = 0.0213).

Conclusions: The FAZ area once decreases along with MH closure; it thereafter increases toward the normal value over time. The postoperative FAZ change was correlated with the VA recovery.

Translational Relevance: This study suggests that the postoperative FAZ area enlargement might be a potential biomarker indicating foveal reconstruction after MH closure.
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http://dx.doi.org/10.1167/tvst.9.8.20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7422767PMC
July 2020

Congenital Retinal Macrovessel Strays into Deep Capillary Plexus.

Ophthalmology 2019 12;126(12):1658

Department of Ophthalmology, Aichi Medical University, Nagakute, Japan.

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http://dx.doi.org/10.1016/j.ophtha.2019.07.006DOI Listing
December 2019

Collateral Vessels in Branch Retinal Vein Occlusion: Anatomic and Functional Analyses by OCT Angiography.

Ophthalmol Retina 2019 09 18;3(9):767-776. Epub 2019 Apr 18.

Department of Ophthalmology, Aichi Medical University, Nagakute, Japan.

Purpose: To analyze collateral vessels (CVs) associated with branch retinal vein occlusion (BRVO) anatomically and functionally using OCT angiography (OCTA).

Design: Retrospective review.

Participants: Twenty-nine consecutive patients with BRVO.

Methods: The distribution of the CVs 12 months after the onset of BRVO was studied using spectral-domain OCTA. En face 3 × 3-mm OCTA images were acquired from 9 locations centered on the fovea and used to create a montage image of an 8.1 × 8.1-mm square. The CVs were identified in 3 separate areas: the radial peripapillary capillary (RPC), superficial capillary plexus (SCP), and deep capillary plexus (DCP) layers. The numbers of CVs were evaluated in 4 regions: zone 1, the area within a 3-mm diameter circle centered on the fovea; zone 2, the area between the 3-mm diameter circle and its outer 6-mm diameter circle; zone 3, the area beyond the 6-mm diameter circle; and the temporal raphe.

Main Outcome Measures: The relationship between the number of CVs and vessel density (VD) in each layer, persistent macular edema (ME) at 12 months, and the number of injections of anti-vascular endothelial growth factor (VEGF) agents.

Results: The number of CVs in zone 1 was correlated negatively (P = 0.0079) with the VD in the SCP, and the numbers of CVs in zone 3 and the temporal raphe were correlated negatively (P = 0.0017 and P = 0.036, respectively) with the VD in the DCP. The number of CVs in the RPC and total number of CVs were also correlated negatively (P = 0.0034 and P = 0.0113, respectively) with the VD in the DCP. In patients with persistent ME, the number of CVs in zone 1 was significantly (P = 0.0156) greater than in patients with nonpersistent ME and correlated positively (P = 0.025) with the number of anti-VEGF injections.

Conclusions: The CVs in BRVO form as result of capillary dropout and are considered to represent remodeling of the retinal capillaries. The CVs around the fovea may be good indicators of persistent ME.
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http://dx.doi.org/10.1016/j.oret.2019.04.015DOI Listing
September 2019

Longitudinal vasculature changes in branch retinal vein occlusion with projection-resolved optical coherence tomography angiography.

Graefes Arch Clin Exp Ophthalmol 2019 Sep 5;257(9):1831-1840. Epub 2019 Jun 5.

Department of Ophthalmology, Aichi Medical University, 1-1 Yazako-karimata, Nagakute, 480-1195, Japan.

Purpose: To analyze vascular changes in branch retinal vein occlusion (BRVO) using projection-resolved optical coherence tomography angiography (PR-OCTA).

Methods: We reviewed 30 consecutive eyes of 30 cases with BRVO retrospectively. PR-OCTA was performed during the acute, intermediate, and remission phases when anti-vascular endothelial growth factor drugs suppress cystic changes. The main outcome measures were vessel density (VD) and retinal thickness changes in the superficial capillary plexus (SCP), intermediate capillary plexus (ICP), and deep capillary plexus (DCP).

Results: The VDs did not change longitudinally in the SCP and DCP during the follow-up period. The VD was significantly (p = 0.0105) greater in the ICP during remission than the acute phase. The full retinal thickness (internal limiting membrane [ILM] to retinal pigment epithelium [RPE]) and inner retinal thickness (ILM to inner plexiform layer [IPL]) decreased significantly (p = 0.0002 and p = 0.0014, respectively) during the follow-up period. When the inner retina was thinner than 117 μm, the VD in the ICP increased significantly (p = 0.045) during the follow-up period. When the inner retinal layer did not become thinner, the VD in the ICP remained unchanged.

Conclusion: PR-OCTA showed the three distinct vascular plexuses in BRVO. The VDs remained unchanged during the follow-up period in the SCP and DCP but increased significantly in the ICP during remission. Inner retinal thinning might cause increases in the VD in the ICP because of projection artifacts and segmentation errors despite using PR-OCTA.
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http://dx.doi.org/10.1007/s00417-019-04371-6DOI Listing
September 2019

Anterior Chamber Fluid-Gas Exchange.

Retina 2019 May 3. Epub 2019 May 3.

Department of Ophthalmology, Aichi Medical University, Nagakute, Japan.

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http://dx.doi.org/10.1097/IAE.0000000000002548DOI Listing
May 2019

Efficacy and safety of intravitreal drug injections using a short 34-gauge needle.

Jpn J Ophthalmol 2019 May 6;63(3):269-275. Epub 2019 Apr 6.

Department of Ophthalmology, Aichi Medical University, 1-1 Yazako-Karimata, Nagakute, 480-1195, Aichi, Japan.

Purpose: To evaluate the efficacy and safety of intravitreal drug injections using a short 34-gauge needle.

Study Design: Retrospective study.

Methods: This study included patients with age-related macular degeneration, diabetic macular edema, or macular edema associated with retinal vein occlusion. We reviewed the medical records of consecutive patients with one of those three diseases treated with antivascular endothelial growth factor (VEGF) agents using an 8-mm-long 34-gauge needle. Sustained intraocular pressure (IOP) elevations were defined as IOP exceeding 21 mmHg or 6-mmHg or higher increases from baseline on 2 consecutive visits at least 1 month apart. The main outcome measures were improved best-corrected visual acuity (BCVA), central retinal thickness (CRT), IOP changes, and incidence of complications related to the 34-gauge needle.

Results: Six hundred ninety-eight injections were administered to 243 consecutive patients (mean age, 74.0 years) and reviewed. The mean follow-up time was 30.2 ± 15.9 weeks. The mean number of intravitreal injections/eye was 2.7 ± 1.8 (range, 1-9). The mean BCVA improved significantly (P < .0001), from 0.43 ± 0.4 logarithm of the minimum angle of resolution (logMAR) units at baseline to 0.36 ± 0.41 logMAR units at the last visit. The mean CRT decreased significantly (P < .0001), from 426.9 ± 168.5 microns at baseline to 297.6 ± 121.1 microns at the last visit. The mean IOP decreased significantly (P < .0001), from 13.6 ± 3.0 mmHg at baseline to 12.9 ± 3.1 mmHg at the visit after the first injection. A retinal tear occurred in 0.14%/injection (1/698). A sustained IOP elevation occurred in 1.29%/injection (9/698).

Conclusion: Despite a few complications, the short 34-gauge needle was efficacious and safe for anti-VEGF intravitreal injections.
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http://dx.doi.org/10.1007/s10384-019-00663-wDOI Listing
May 2019

Evaluation of retinal nonperfusion in branch retinal vein occlusion using wide-field optical coherence tomography angiography.

Acta Ophthalmol 2019 Sep 22;97(6):e913-e918. Epub 2019 Mar 22.

Department of Ophthalmology, Osaka University Graduate School of Medicine, Yamadaoka, Japan.

Purpose: To characterize wide-field optical coherence tomography angiography (OCTA) features of retinal nonperfusion in eyes with branch retinal vein occlusion (BRVO).

Methods: Automated scanning of five 12 × 12-mm areas of swept-source OCTA and wide-field fluorescein angiography (FA) images was performed in a consecutive case series of 27 eyes in 27 patients with BRVO in this institutional cross-sectional study. The correlation between the areas of retinal nonperfusion detected by both examinations was assessed. Panoramic images obtained in five 12 × 12-mm OCTA scans in eyes with retinal nonperfusion were binarized or skeletonized, and the associations between vascular parameters such as vascular density (VD) and vascular length (VL) with the wide-field FA characteristics were evaluated.

Results: The mean area of retinal nonperfusion in the OCTA images was 81.0 ± 66.8 mm (range, 0.0-188.8). The mean areas of retinal nonperfusion in FA and the total FA images were, respectively, 84.7 ± 72.5 mm (range, 0.0-221.9) and 184.1 ± 167.7 mm (range, 0.0-515.0). The mean VD was 27.6 ± 3.5% (range, 19.6-33.7), and the mean VL was 12.4 ± 8.5% (range, 5.4-31.3). Separate regression analyses of the areas of retinal nonperfusion in FA (p = 0.0004, R  = 0.4627) and the total FA (p = 0.0008, R  = 0.4214) images showed a significant association with the VL.

Conclusions: OCTA images based on wide-field technologies can quantitatively evaluate retinal nonperfusion in eyes with BRVO.
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http://dx.doi.org/10.1111/aos.14087DOI Listing
September 2019

Chorioretinal Shunt Vessel in Eyes with Central Retinal Vein Occlusion after Radial Optic Neurotomy.

Ophthalmology 2018 09 21;125(9):1409. Epub 2018 Aug 21.

Department of Ophthalmology, Aichi Medical University, Nagakute, Japan.

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http://dx.doi.org/10.1016/j.ophtha.2018.06.035DOI Listing
September 2018

Sequential Observations of Conversion from Nonischemic to Ischemic Central Retinal Vein Occlusion Using Optical Coherence Tomography Angiography.

Case Rep Ophthalmol Med 2018 23;2018:1354217. Epub 2018 Apr 23.

Department of Ophthalmology, Aichi Medical University, Nagakute, Japan.

We report the sequential changes of retinal vessels observed by optical coherence tomography angiography (OCTA) in a case of nonischemic central retinal vein occlusion (CRVO) that converted to ischemic CRVO. An 81-year-old woman visited our Retina Clinic because of visual acuity loss in the left eye. Funduscopic examination showed venous tortuosity and intraretinal hemorrhage in all four quadrants of the fundus. OCT showed macular edema. Fluorescein angiography (FA) and OCTA showed loss of small capillaries. Nonischemic CRVO was diagnosed. Antivascular endothelial growth factor (VEGF) treatment resolved the edema and improved visual acuity. However, during follow-up, capillary dropout was observed on OCTA, which gradually enlarged. Eventually, FA confirmed the conversion to ischemic CRVO. In this case, sequential observations using OCTA showed that nonischemic CRVO did not convert to ischemic CRVO abruptly but occurred stepwise. Additionally, vascular changes began around the veins and blood flow changes were observed more clearly in deep capillary plexus than in superficial capillary plexus.
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http://dx.doi.org/10.1155/2018/1354217DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5937511PMC
April 2018

A Randomized Trial of a Short 34-Gauge Needle for Intravitreal Injections.

Ophthalmology 2018 06 2;125(6):947-948. Epub 2018 Mar 2.

Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi, Japan.

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http://dx.doi.org/10.1016/j.ophtha.2018.01.038DOI Listing
June 2018

Author Response: Gap in Capillary Perfusion on Optical Coherence Tomography Angiography.

Invest Ophthalmol Vis Sci 2017 06;58(7):3045

Department of Ophthalmology, Aichi Medical University, Nagakute, Japan.

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http://dx.doi.org/10.1167/iovs.17-22130DOI Listing
June 2017

Gap in Capillary Perfusion on Optical Coherence Tomography Angiography Associated With Persistent Macular Edema in Branch Retinal Vein Occlusion.

Invest Ophthalmol Vis Sci 2017 04;58(4):2038-2043

Department of Ophthalmology, Aichi Medical University, Nagakute, Japan.

Purpose: To evaluate correlations between persistent macular edema associated with branch retinal vein occlusion (BRVO) and the macular perfusion status in the superficial capillary plexus (SCP) and deep capillary plexus (DCP) using optical coherence tomography angiography (OCTA).

Methods: Retrospective, case-control study. Twenty patients with BRVO followed for 12 months or more were enrolled. Persistent macular edema was defined as central retinal thickness exceeding 300 μm that persisted or recurred less than 3 months after the final treatment. We compared two groups (i.e., seven eyes with persistent macular edema and 13 eyes without macular edema). The macular perfusion status was evaluated using OCTA. We defined a gap vessel as a residual vessel in the SCP that existed simultaneously with capillary loss in the DCP. The gap vessels were determined by subtracting the vessel images of the DCP from the images of the SCP using an image processing technique.

Results: In eyes with persistent macular edema, the area with gap vessels was significantly (P = 0.0013) larger than in eyes without macular edema (14.34% vs. 8.02%). Other factors evaluated (i.e., the area of the foveal avascular zone, superficial vessel density, and deep vessel density) did not differ significantly (P = 0.66, P = 0.23, P = 0.34, respectively) between the groups.

Conclusions: The difference in capillary loss between the SCP and DCP can facilitate development of persistent macular edema in BRVO.
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http://dx.doi.org/10.1167/iovs.17-21447DOI Listing
April 2017

Characteristics of cases with postoperative vitreous hemorrhage after 25-gauge vitrectomy for repair of proliferative diabetic retinopathy.

Graefes Arch Clin Exp Ophthalmol 2017 Apr 21;255(4):665-671. Epub 2016 Oct 21.

Osaka Rosai Hospital Clinical Research Center for Occupational Sensory Organ Disability, Sakai, Japan.

Purpose: The purpose of this study was to compare ocular and systemic parameters between proliferative diabetic retinopathy (PDR) cases with postoperative vitreous hemorrhage (PVH) and those without PVH after 25-gauge vitrectomy, and to investigate the predictors of PVH.

Methods: The medical records of 106 eyes of 78 consecutive patients who underwent primary 25-gauge vitrectomy were reviewed.

Results: The incidences of early and late PVH were found to be 18.9 % (20/106 eyes) and 17.9 % (19/106 eyes) respectively. On multiple logistic regression analysis, intraoperative bleeding from new vessels on the disc was identified as the most important factor, with the greatest odds ratio, for the development of early PVH (odds ratio = 3.395, P = 0.134), while the HbA1c level was identified as the most important significant factor, with the greatest odds ratio, for the development of late PVH (odds ratio = 1.403, P = 0.014).

Conclusions: Early PVH tends to occur in severe PDR cases, while late PVH tends to occur in cases with poor diabetic control.
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http://dx.doi.org/10.1007/s00417-016-3522-8DOI Listing
April 2017

Analysis of choroidal folds in acute Vogt-Koyanagi-Harada disease using high-penetration optical coherence tomography.

Graefes Arch Clin Exp Ophthalmol 2015 Jun 10;253(6):959-64. Epub 2015 Feb 10.

Department of Ophthalmology E7, Osaka University Medical School, 2-2 Yamada-oka Suita, 565-0871, Osaka, Japan.

Purpose: To characterize patients with Vogt-Koyanagi-Harada (VKH) disease with choroidal folds (CFs) and determine how the foveal choroidal thickness changes after initial treatment using high-penetration optical coherence tomography (HP-OCT).

Methods: In this retrospective observational study, we analyzed 42 eyes of 21 patients with new-onset VKH disease to determine the demographic and clinical differences between patients with and without CFs.

Results: Twenty-four eyes (57.1 %) of 13 patients with VKH disease had CFs. The mean age (p = 0.0009) of patients with CFs was significantly higher than that of those without CFs (49.1 vs 39.4 years respectively). The frequency of disc swelling (p = 0.0001) was significantly higher in eyes with CFs than in those without CFs (95.8 % vs 38.9 %). The choroidal thickness at the first visit (p = 0.0011) was significantly greater in eyes with CFs than in those without CFs (794 ± 144 μm vs 649 ± 113 μm). The choroid 6 months after the initial treatment (p = 0.0118) was significantly thinner in eyes with CFs than in those without CFs (270 ± 92 μm vs 340 ± 80 μm). The frequency of sunset glow fundus at 6 months (p = 0.0334) in eyes with CFs was significantly higher than in those without CFs (62.5 % vs 27.8 %).

Conclusion: The development of CFs in patients with VKH disease was significantly correlated with age, disc swelling, and choroidal thickness. The eyes with CFs frequently developed a sunset glow fundus. The findings suggested that patients with CFs might have severe and longstanding inflammation of the choroidal tissues.
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http://dx.doi.org/10.1007/s00417-015-2945-yDOI Listing
June 2015