Yasuda Shintaro, Yoshida Takeshi, Suzuki Yudai, Sugahara Yuiko, Lee Junfuku, Kamoi Koju, Horie Shintaro, Takase Hiroshi, Ohno-Matsui Kyoko
Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Advanced Ophthalmic Imaging, Tokyo Medical and Dental University, Tokyo, Japan.
Graefes Arch Clin Exp Ophthalmol. 2025 Apr;263(4):1089-1103. doi: 10.1007/s00417-024-06693-6. Epub 2024 Nov 25.
This study examined six patients with Vogt-Koyanagi-Harada (VKH) disease using retromode infrared scanning laser ophthalmoscopy (RMI-SLO).
We conducted a single-center retrospective review of the medical records of six patients diagnosed with VKH disease. The RMI-SLO images were compared to those obtained using color fundus photography, optical coherence tomography (OCT), and dye-based retinal angiography.
In the acute phase of VKH disease, RMI-SLO revealed pseudo-three-dimensional (3D) regions and wavy patterns. These observations corresponded to the areas of serous retinal detachment (sRD) and choroidal folds identified on OCT. Notably, the detection of pseudo-3D regions by RMI-SLO proved to be more effective than color fundus photography in identifying sRDs. Hyper-reflective lines inside the sRDs were observed in the RMI-SLO images and were consistent with the fibrinous membranes observed in the OCT images. The hyper-reflective choroidal vasculature in RMI-SLO images was notably absent, a finding like the fuzzy pattern of large stromal choroidal vessels observed in indocyanine green angiography images. Following steroid treatment, these abnormal findings reverted to normal.
RMI-SLO imaging could serve as an alternative option for both pre- and post-treatment assessments in VKH disease. Moreover, it has the potential to reduce the need for retinal angiography.
What is known Optical coherence tomography (OCT) and indocyanine green angiography (ICGA) are essential for the diagnosis of Vogt-Koyanagi-Harada (VKH) disease. However, it is difficult to visualize a wide area of the fundus with OCT, and ICGA carries risks of allergic reactions or shock. What is new Retromode infrared scanning laser ophthalmoscopy (RMI-SLO) can demonstrate pseudo-three-dimensional regions and wavy patterns corresponding to serous retinal detachment and choroidal folds in the acute stage of VKH disease. Hyper-reflective choroidal vasculature was absent in the acute stage of VKH disease on RMI-SLO and may correlate with choroidal thickening. RMI-SLO could be an alternative option for the assessment of VKH disease and has the potential to reduce the need for dye-based retinal angiography.
本研究使用后向模式红外扫描激光检眼镜（RMI-SLO）对6例伏格特-小柳-原田（VKH）病患者进行了检查。
我们对6例诊断为VKH病患者的病历进行了单中心回顾性研究。将RMI-SLO图像与彩色眼底照相、光学相干断层扫描（OCT）和染料视网膜血管造影所获得的图像进行比较。
在VKH病的急性期，RMI-SLO显示出假三维（3D）区域和波浪状图案。这些观察结果与OCT上识别出的浆液性视网膜脱离（sRD）和脉络膜皱褶区域相对应。值得注意的是，在识别sRD方面，RMI-SLO检测假3D区域比彩色眼底照相更有效。在RMI-SLO图像中观察到sRD内的高反射线，这与OCT图像中观察到的纤维蛋白膜一致。RMI-SLO图像中明显没有高反射的脉络膜血管，这一发现类似于吲哚菁绿血管造影图像中观察到的大脉络膜基质血管的模糊图案。类固醇治疗后，这些异常发现恢复正常。
RMI-SLO成像可作为VKH病治疗前和治疗后评估的替代选择。此外，它有可能减少视网膜血管造影的需求。
已知内容 光学相干断层扫描（OCT）和吲哚菁绿血管造影（ICGA）对伏格特-小柳-原田（VKH）病的诊断至关重要。然而，用OCT很难可视化眼底的大片区域，并且ICGA存在过敏反应或休克的风险。新内容 后向模式红外扫描激光检眼镜（RMI-SLO）可以显示与VKH病急性期浆液性视网膜脱离和脉络膜皱褶相对应的假三维区域和波浪状图案。在VKH病急性期的RMI-SLO上没有高反射的脉络膜血管，这可能与脉络膜增厚有关。RMI-SLO可能是评估VKH病的替代选择，并且有可能减少对染料视网膜血管造影的需求。
