Automatic measurement of choroidal thickness with swept-source optical coherence tomography in chronic Vogt-Koyanagi-Harada disease: 3 years' follow-up

Purpose: The course of Vogt-Koyanagi-Harada (VKH) disease is typically assessed qualitatively using indocyanine green angiography (ICGA) and enhanced-depth imaging optical coherence tomography (EDI-OCT). However, a quantitative approach could improve accuracy and objectivity. The aim of this study was to assess the clinical value of the automated measurement capabilities of swept-source optical coherence tomography (SS-OCT) to measure choroidal thickness (quantitative approach) in chronic VKH.

Methods: Prospective, longitudinal case-control study at a tertiary university hospital involving 23 chronic VKH patients (9 convalescent and 14 quiescent) and 17 age-matched controls. Choroidal thickness was automatically measured with SS-OCT.

Results: Choroidal thinning and improved vision were associated with treatment while increasing thickness and worsening vision were associated with posterior relapse. Overall, 41.6% of asymptomatic (no change in visual acuity) recurrences in the convalescent group and 25% of recurrences in the quiescent group were detected by SS-OCT. All recurrences diagnosed by SS-OCT showed signs of inflammation on ICGA.

Conclusions: Automatic measurement of choroidal thickness with SS-OCT is a rapid, non-invasive method of detecting posterior segment recurrences and treatment response in VKH patients, and could reduce the need for angiography to monitor this disease.