fibrin and Uveomeningoencephalitic-Syndrome

The purpose of the study was to investigate clinical relevance of fibrin membranous structure (FMS) in the photoreceptor outer segments on spectral-domain optical coherence tomography (SD-OCT) in untreated initial-onset acute Vogt-Koyanagi-Harada (VKH) disease.. Clinical charts of 39 patients (78 eyes) diagnosed with initial-onset VKH disease were retrospectively reviewed. Age, gender, period from the onset of symptoms to first visit, visual acuity (VA), intraocular pressure (IOP), anterior chamber cells, serous retinal detachment (SRD), SD-OCT findings, as well as fluorescein (FA), and indocyanine green angiography (ICGA) were collected.. FMS was observed in 24 out of 39 VKH patients in either eye (61.5%). VKH patients with FMS (FMS group) were significantly younger and had the shorter period from the onset of symptoms to the first visit compared with those without FMS (non-FMS group). Mean logMAR VA and proportion of pooling of dye, mean central retinal thickness (CRT) were significantly higher in FMS group than in non-FMS group. In contrast, hyperfluorescence of the optic disc on FA was more in non-FMS group than in FMS group. Significant positive correlations between CRT and logMAR VA or IOP were only observed in the FMS group. Total amount of corticosteroids was significantly greater in FMS group than in non-FMS group. However, there were no significant differences in LogMAR VA and IOP between two groups at 6 months after treatment initiation.. FMS on SD-OCT is a critical feature observed in the early stage of initial-onset acute VKH disease, which is more common in younger patients and is related to the disease activity.

Topics: Clinical Relevance; Fibrin; Fluorescein Angiography; Humans; Retina; Retrospective Studies; Tomography, Optical Coherence; Uveomeningoencephalitic Syndrome

To determine if the inflammatory composition of subretinal fluid in Vogt-Koyanagi-Harada (VKH) serous retinal detachments is predictive of photoreceptor injury, and to quantify photoreceptor recovery, following resolution of these detachments.. Optical density (OD) measurements of spectral-domain optical coherence tomography (SD-OCT) scans were used to derive the fibrinous index, a measure of the inflammatory composition of subretinal fluid. In order to assess photoreceptor status, photoreceptor outer segment (PROS) volume was measured from SD-OCT scans.. The fibrinous index of subretinal fluid in VKH uveitis was strongly correlated with the PROS volume following resolution of subretinal fluid (r = -0.70, p = 0.006). Following fluid resolution, both PROS volume (p < 0.0001) and visual acuity (p = 0.0015) improved.. The fibrinous index of subretinal fluid during the acute stage of VKH can predict photoreceptor status following resolution of subretinal fluid. PROS volume is a useful measure of photoreceptor recovery in VKH.

Topics: Adult; Female; Fibrin; Humans; Male; Panuveitis; Recovery of Function; Retinal Detachment; Retinal Photoreceptor Cell Outer Segment; Subretinal Fluid; Tomography, Optical Coherence; Uveomeningoencephalitic Syndrome; Visual Acuity