Elevated choroidal blood flow velocity during systemic corticosteroid therapy in Vogt-Koyanagi-Harada disease

Acta Ophthalmol. 2008 Dec;86(8):902-7. doi: 10.1111/j.1755-3768.2008.01384.x. Epub 2008 Nov 12.

Abstract

Purpose: Laser speckle flowgraphy (LSFG) can be used to non-invasively visualize the haemodynamics of choroidal circulation and the vascular pattern. The purpose of this study was to examine the ability of LSFG to quantitatively evaluate blood flow velocity at the macula in patients with Vogt-Koyanagi-Harada (VKH) disease before and after systemic corticosteroid therapy.

Methods: Prednisolone (200 mg/day) was systemically administered in 10 VKH disease patients with serous retinal detachment at the macular area. The drug was gradually tapered to zero over a 6-month period. Laser speckle flowgraphy measurements were taken in the 20 eyes of these patients at their initial visit and at 1, 4 and 12 weeks after the onset of therapy. Square blur rate (SBR), a quantitative index of relative blood flow velocity, was calculated using LSFG.

Results: Serous retinal detachment resolved within 4 weeks after treatment and visual acuities improved to > 1.0 in almost all cases. There were significant increases in average SBR at the macula at 4 weeks after treatment compared with at 1 week after treatment, and also at 12 weeks after treatment compared with at 4 weeks after treatment.

Conclusions: These results suggest that systemic corticosteroid therapy improves inflammation-related impairment in choroidal blood flow velocity at the macula. Laser speckle flowgraphy can evaluate the effect of systemic corticosteroid therapy by enabling comparisons between measurements of blood flow velocity, which is considered to reflect inflammation activity in the choroid.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Flow Velocity / drug effects*
  • Choroid / blood supply*
  • Female
  • Fluorescein Angiography
  • Glucocorticoids / administration & dosage*
  • Humans
  • Injections, Intravenous
  • Laser-Doppler Flowmetry / methods
  • Macula Lutea / blood supply
  • Male
  • Middle Aged
  • Prednisolone / administration & dosage*
  • Retinal Detachment / drug therapy
  • Retinal Detachment / etiology
  • Retinal Detachment / physiopathology
  • Treatment Outcome
  • Uveomeningoencephalitic Syndrome / complications
  • Uveomeningoencephalitic Syndrome / diagnosis
  • Uveomeningoencephalitic Syndrome / drug therapy*
  • Uveomeningoencephalitic Syndrome / physiopathology*
  • Young Adult

Substances

  • Glucocorticoids
  • Prednisolone