The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Prevention and Treatment of Major Blindness Eye Diseases, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Centre for Ocular Diseases, Chongqing, P.R. China.
Department of Ophthalmology, Daping Hospital, Army Medical University, Chongqing, P.R. China.
Transl Vis Sci Technol. 2024 Aug 1;13(8):15. doi: 10.1167/tvst.13.8.15.
To study the impact of early and late treatment on chorioretinal microvasculature in Vogt-Koyanagi-Harada (VKH) disease using optical coherence tomography angiography (OCTA).
A total of 103 patients with VKH disease were divided into early (group 1, starting treatment within 2 months after disease onset) and late (group 2, starting treatment 2 months after disease onset) treatment groups. Flow area (FA) and vessel density (VD) of the retinal superficial vascular complex (SVC) and deep vascular complex (DVC), FA of the choriocapillaris, three-dimensional choroidal vascular volume (CVV), and choroidal vascularity index (CVI) were analyzed and compared to 103 healthy individuals. The relationship between the final best-corrected visual acuity (BCVA) and the aforementioned parameters was also analyzed.
FA of the SVC (all P < 0.05, except 0-1 mm P = 0.087), DVC (all P < 0.05), choriocapillaris (1-2.5 mm P = 0.033), and CVV (all P < 0.05) were lower in group 2 as compared to group 1. Compared to healthy controls, FA of the SVC (all P < 0.001, except 0-1 mm P = 0.104) and DVC (all P < 0.05), VD of the SVC (1-2.5 mm P = 0.001) and DVC (1-5 mm P = 0.003, 2.5-5 mm P < 0.001), FA of the choriocapillaris (all P < 0.05), and CVV (total area P = 0.049, 1-5 mm P = 0.045, 2.5-5 mm P = 0.041) were lower in group 2, while FA (all P < 0.05, except 0-1 mm P = 0.925) and VD (1-5 mm P = 0.003, 2.5-5 mm P = 0.004) of the DVC and FA of the choriocapillaris (total area P = 0.007, 0-1 mm P < 0.001, 1-2.5 mm P = 0.007) were lower in group 1. There was no significant difference concerning CVI among groups (all P > 0.05). FA of the SVC, DVC, and choriocapillaris and VD of DVC and CVI were negatively associated with the final logarithm of the minimum angle of resolution BCVA.
Patients with VKH disease who are treated within 2 months of disease onset showed a better chorioretinal microvascular outcome as defined by OCTA compared to those treated late.
Our study employs OCTA to design three-dimensional metrics for the retina and choroid, bridging the gap between traditional two-dimensional OCTA findings and enhanced clinical outcomes for patients with VKH disease.
利用光相干断层扫描血管造影术（OCTA）研究 Vogt-Koyanagi-Harada（VKH）疾病中早期和晚期治疗对脉络膜视网膜微循环的影响。
将 103 例 VKH 病患者分为早期（组 1，发病后 2 个月内开始治疗）和晚期（组 2，发病后 2 个月开始治疗）治疗组。分析并比较视网膜浅层血管复合体（SVC）和深层血管复合体（DVC）、脉络膜毛细血管 FA、脉络膜毛细血管体积（CVV）的 FA、脉络膜血管密度（VD）和脉络膜血管指数（CVI），并与 103 名健康个体进行比较。还分析了最终最佳矫正视力（BCVA）与上述参数之间的关系。
与组 1 相比，组 2 的 SVC（所有 P < 0.05，除外 0-1mm P = 0.087）、DVC（所有 P < 0.05）、脉络膜毛细血管（1-2.5mm P = 0.033）和 CVV（所有 P < 0.05）的 FA 均较低。与健康对照组相比，SVC 的 FA（所有 P < 0.001，除外 0-1mm P = 0.104）和 DVC（所有 P < 0.05）、SVC 的 VD（1-2.5mm P = 0.001）和 DVC（1-5mm P = 0.003，2.5-5mm P < 0.001）、脉络膜毛细血管的 FA（所有 P < 0.05）和 CVV（总面积 P = 0.049，1-5mm P = 0.045，2.5-5mm P = 0.041）较低，而 DVC 的 FA（所有 P < 0.05，除外 0-1mm P = 0.925）和 VD（1-5mm P = 0.003，2.5-5mm P = 0.004）和脉络膜毛细血管的 FA（总面积 P = 0.007，0-1mm P < 0.001，1-2.5mm P = 0.007）在组 1 中较低。各组间 CVI 无显著差异（均 P > 0.05）。SVC、DVC 和脉络膜毛细血管的 FA 和 DVC 的 VD 和 CVI 与最终最小分辨角视力对数呈负相关。
与晚期治疗相比，发病后 2 个月内开始治疗的 VKH 病患者的脉络膜视网膜微血管结果通过 OCTA 定义更好。
李俊杰
