Gupta Vishali, Gupta Amod, Gupta Pawan, Sharma Aman
Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Am J Ophthalmol. 2009 Jan;147(1):148-153.e2. doi: 10.1016/j.ajo.2008.07.028. Epub 2008 Oct 2.
To describe changes in the retinal pigment epithelium (RPE) corresponding to the choroidal striations in acute-stage Vogt-Koyanagi-Harada (VKH) disease.
Prospective, consecutive case series.
Four patients (eight eyes) with acute-stage VKH disease were studied. All underwent fundus fluorescein angiography (FFA), ultrasonography, and spectral-domain optical coherence tomography (SD OCT). The main outcome measure was the correlation of the findings seen on a 3-dimensional (3D) single-layer RPE map constructed on SD OCT with the serous retinal detachment (RD) and choroidal striations.
The retina inner to external limiting membrane did not show any structural alteration in any of the eyes. The 3D single-layer RPE map showed undulations and bumps on the RPE surface in all the eyes. The troughs of the undulations were noted to correspond to the choroidal striations seen as hypofluorescent lines in the early phase of FFA. The bumps over the undulations corresponded to the pinpoint hyperfluorescent dots on FFA, resulting in the development of serous RDs over the troughs, thus obscuring the hypofluorescent lines in the late phase of fluorescein angiograms.
The troughs of the RPE undulations were seen clinically as choroidal striations in the acute uveitic stage of VKH disease.
描述急性Vogt-小柳-原田（VKH）病中与脉络膜条纹相对应的视网膜色素上皮（RPE）变化。
前瞻性连续病例系列研究。
对4例（8只眼）急性VKH病患者进行研究。所有患者均接受了眼底荧光血管造影（FFA）、超声检查和光谱域光学相干断层扫描（SD OCT）。主要观察指标是在SD OCT构建的三维（3D）单层RPE图上观察到的结果与浆液性视网膜脱离（RD）和脉络膜条纹之间的相关性。
所有患眼中，内界膜以内的视网膜均未显示任何结构改变。3D单层RPE图显示所有患眼的RPE表面有起伏和隆起。起伏的低谷对应于FFA早期所见的脉络膜条纹，表现为低荧光线。起伏上的隆起对应于FFA上的点状高荧光点，导致浆液性RD在低谷处形成，从而在荧光血管造影晚期使低荧光线模糊不清。
在VKH病急性葡萄膜炎期，RPE起伏的低谷在临床上表现为脉络膜条纹。
