Hirooka Kiriko, Saito Wataru, Namba Kenichi, Takemoto Yuko, Mizuuchi Kazuomi, Uno Tomoe, Tagawa Yoshiaki, Hashimoto Yuki, Ishida Susumu
Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Graefes Arch Clin Exp Ophthalmol. 2015 Apr;253(4):609-17. doi: 10.1007/s00417-014-2927-5. Epub 2015 Jan 27.
To investigate the relationship between circulation hemodynamics and morphology in the choroid during systemic corticosteroid therapy for patients with Vogt-Koyanagi-Harada (VKH) disease.
This retrospective case series includes 18 eyes of nine patients with VKH disease (two men and seven women; average age, 40.8 years) who received systemic corticosteroid therapy. Laser speckle flowgraphy (LSFG) and enhanced-depth imaging optical coherence tomography (EDI-OCT) were performed before treatment and at 1 week and 1 and 3 months after treatment. The average values of the mean blur rate (MBR) at the macula and the central choroidal thickness (CCT) were compared at each stage.
The changing rates of the average MBR significantly increased at all examinations after the start of treatment compared with the pre-treatment value with resolution of serous retinal detachment (SRD) (P = 0.0002 for all). The CCT decreased significantly at all examinations after the start of treatment compared with the pre-treatment value (P = 0.0002 for all). Changes in MBR and CCT during the 3-month follow-up period correlated significantly (R = -0.5913, P = 0.0097). The best-corrected visual acuity at pre-treatment correlated significantly with the changing rate of the MBR from 0 to 3 months (R = 0.5944, P = 0.0093) but not with CCT.
Our data suggest that circulatory disturbances and increased thickness of the choroid relate to the pathogenesis of VKH disease with link mutually. LSFG is useful as an index for evaluating the choroiditis activity of VKH disease as well as EDI-OCT.
探讨伏格特-小柳-原田（VKH）病患者全身应用糖皮质激素治疗期间脉络膜循环血流动力学与形态学之间的关系。
本回顾性病例系列研究纳入了9例接受全身糖皮质激素治疗的VKH病患者的18只眼（2例男性，7例女性；平均年龄40.8岁）。在治疗前、治疗后1周、1个月和3个月进行激光散斑血流图（LSFG）和增强深度成像光学相干断层扫描（EDI-OCT）检查。比较各阶段黄斑区平均模糊率（MBR）和脉络膜中央厚度（CCT）的平均值。
与治疗前相比，治疗开始后所有检查中平均MBR的变化率均显著增加，同时浆液性视网膜脱离（SRD）消退（所有P=0.0002）。与治疗前相比，治疗开始后所有检查中CCT均显著降低（所有P=0.0002）。3个月随访期内MBR和CCT的变化显著相关（R=-0.5913，P=0.0097）。治疗前的最佳矫正视力与0至3个月MBR的变化率显著相关（R=0.5944，P=0.0093），但与CCT无关。
我们的数据表明，循环障碍和脉络膜厚度增加与VKH病的发病机制相互关联。LSFG与EDI-OCT一样，可作为评估VKH病脉络膜炎活动的指标。
