{"title":"Vogt-Koyanagi-Harada 病的 Retromode 红外线扫描激光眼底镜检查。","authors":"Shintaro Yasuda, Takeshi Yoshida, Yudai Suzuki, Yuiko Sugahara, Junfuku Lee, Koju Kamoi, Shintaro Horie, Hiroshi Takase, Kyoko Ohno-Matsui","doi":"10.1007/s00417-024-06693-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This study examined six patients with Vogt-Koyanagi-Harada (VKH) disease using retromode infrared scanning laser ophthalmoscopy (RMI-SLO).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p><p><strong>Key messages: </strong>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.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Retromode Infrared Scanning Laser Ophthalmoscopy in Vogt-Koyanagi-Harada Disease.\",\"authors\":\"Shintaro Yasuda, Takeshi Yoshida, Yudai Suzuki, Yuiko Sugahara, Junfuku Lee, Koju Kamoi, Shintaro Horie, Hiroshi Takase, Kyoko Ohno-Matsui\",\"doi\":\"10.1007/s00417-024-06693-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>This study examined six patients with Vogt-Koyanagi-Harada (VKH) disease using retromode infrared scanning laser ophthalmoscopy (RMI-SLO).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p><p><strong>Key messages: </strong>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.</p>\",\"PeriodicalId\":12795,\"journal\":{\"name\":\"Graefe’s Archive for Clinical and Experimental Ophthalmology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2024-11-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Graefe’s Archive for Clinical and Experimental Ophthalmology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00417-024-06693-6\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Graefe’s Archive for Clinical and Experimental Ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00417-024-06693-6","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
Retromode Infrared Scanning Laser Ophthalmoscopy in Vogt-Koyanagi-Harada Disease.
Purpose: This study examined six patients with Vogt-Koyanagi-Harada (VKH) disease using retromode infrared scanning laser ophthalmoscopy (RMI-SLO).
Methods: 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.
Results: 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.
Conclusions: 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.
Key messages: 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.
期刊介绍：
Graefe''s Archive for Clinical and Experimental Ophthalmology is a distinguished international journal that presents original clinical reports and clini-cally relevant experimental studies. Founded in 1854 by Albrecht von Graefe to serve as a source of useful clinical information and a stimulus for discussion, the journal has published articles by leading ophthalmologists and vision research scientists for more than a century. With peer review by an international Editorial Board and prompt English-language publication, Graefe''s Archive provides rapid dissemination of clinical and clinically related experimental information.
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