Clinical and multimodal imaging characteristics of eyes with Vogt-Koyanagi-Harada disease: An Egyptian experience

Mahmood O Mekkawy; Yousef Ahmed Fouad; Mohamed Nowara; Ihab Abdel Aziz

doi:10.4103/ojo.ojo_376_21

Clinical and multimodal imaging characteristics of eyes with Vogt-Koyanagi-Harada disease: An Egyptian experience

Oman J Ophthalmol. 2023 Feb 21;16(1):88-93. doi: 10.4103/ojo.ojo_376_21. eCollection 2023 Jan-Apr.

Authors

Mahmood O Mekkawy¹, Yousef Ahmed Fouad^{1

2}, Mohamed Nowara^{1

3}, Ihab Abdel Aziz^{1

4}

Affiliations

¹ Al Mashreq Eye Center, Cairo, Egypt.
² Department of Ophthalmology, Ain Shams University Hospitals, Giza, Egypt.
³ Department of Ophthalmology, Electricity Hospital, Cairo, Egypt.
⁴ Vitreoretinal Service, The Memorial Institute for Ophthalmic Research, Giza, Egypt.

Abstract

Background: Vogt-Koyanagi-Harada (VKH) disease is a vision-threatening inflammatory disorder that is challenging in diagnosis and management.

Methods: Retrospective, record-based analysis of 54 eyes belonging to 27 adult patients that fulfilled the revised diagnostic criteria for VKH between January 2018 and January 2021. Demographic, clinical, and imaging data on presentation and during follow-up visits were collected for each patient. Available imaging studies included B-scan ultrasonography (B-scan US), spectral domain optical coherence tomography (OCT), fundus fluorescein angiography (FFA), and OCT angiography (OCT-A).

Results: The female-to-male ratio was 2.38:1. Nineteen patients (70.37%) presented during an initial attack, while eight patients (29.63%) presented during recurrence. The most commonly presenting sign in the posterior segment was exudative retinal detachment (44 eyes, 81.48%). B-scan US was utilized in 4 eyes (7.41%), OCT was utilized in 48 eyes (88.89%) with the most common finding being subretinal fluid (43 eyes, 89.58%), FFA was performed in 39 eyes (72.22%) with the most common finding being punctate hyperfluorescence and late dye pooling (33 eyes, 84.62%), and OCT-A was performed in 30 eyes (55.56%), in which choriocapillaris flow deficit that correlated with disease activity was detectable in 25 eyes (83.33%). Improved visual acuity was noted in 85% of the eyes that were followed up.

Conclusion: Early diagnosis and treatment of VKH result in favorable visual outcome. Multimodal imaging, with the recent addition of OCT-A, provides complementary data that could serve in diagnosis and monitoring.

Keywords: Choroiditis; Harada disease; Vogt–Koyanagi–Harada disease; multimodal imaging; optical coherence tomography angiography.