Evaluation of the Activity of Vogt–Koyanagi–Harada Disease; A Comparison of Indocyanine Green Angiography Scoring, Enhanced Depth Imaging Optical Coherence Tomography, and Choroidal Vascularity Index

Abstract

Purpose To investigate the correlation between choroidal biomarkers using enhanced depth imaging optical coherence tomography (EDI-OCT) and indocyanine green angiography (ICGA) scoring for monitoring the activity of Vogt–Koyanagi–Harada (VKH). Methods Patients who were not in the acute phase of VKH were recruited. Simultaneous EDI-OCT and ICGA were captured in seven patients only at baseline, in six patients at the 3-month follow-up, and in two patients at both the 6- and 9-month follow-ups. Subfoveal choroidal thickness (SFCT), subfoveal choroidal area (SFCA), and choroidal vascular index (CVI) were measured on EDI-OCT using FIJI software and a denoising system. ICGA scoring was performed. Results Fifteen subjects with the median of 4-month follow-up were recruited. Forty-eight pairs of EDI-OCT and ICGA were investigated. In univariate analysis, ICGA scores were positively associated with SFCT, and SFCA, but negatively with CVI. The strength of correlation between ICGA scores and SFCT was strong (correlation coefficient: 0.91). In multivariate analysis, only SFCT remained significant (B: 2.4, 95% confidence interval: 1.9–3.0; P < 0.001). Conclusions SFCT can be an acceptable representative of the subclinical inflammatory activity of VKH. As an alternative to ICGA, SFCT functions better than SFCA and CVI.

Keywords

• choroidal vascular index
• enhanced depth imaging optical coherence tomography
• indocyanine green angiography
• subfoveal choroidal area
• subfoveal choroidal thickness
• vogt–koyanagi–harada