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Article: Choroidal evaluation using enhanced depth imaging spectral-domain optical coherence tomography in Vogt-Koyanagi-Harada disease

TitleChoroidal evaluation using enhanced depth imaging spectral-domain optical coherence tomography in Vogt-Koyanagi-Harada disease
Authors
Keywordschoriocapillaris
optical coherence tomography
pathology
uveomeningoencephalitic syndrome
Vogt-Koyanagi-Harada disease
Issue Date2011
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.retinajournal.com
Citation
Retina, 2011, v. 31 n. 3, p. 502-509 How to Cite?
AbstractBACKGROUND: Current imaging modalities used in the evaluation of Vogt-Koyanagi-Harada (VKH) disease include ultrasound, fluorescein angiogram, indocyanine green angiography, and optical coherence tomography (OCT). However, they all fail to give detailed information on the ultrastructural changes of the choroid. A recent technique using OCT termed "enhanced depth imaging" produces high-resolution cross-sectional images of the whole thickness of the choroid. The purpose of the study was to describe a novel imaging finding in the choroid in cases of VKH uveitis and to assess for interobserver agreement of this new physical sign. METHODS: This is an age-matched, sex-matched, and spherical equivalent-matched, case-control, cross-sectional study. Six VKH patients in acute and convalescent stages underwent choroidal imaging using enhanced depth imaging spectral-domain OCT imaging. A horizontal enhanced depth imaging spectral-domain OCT scan across the fovea was selected for each eye and was compared with a scan from an age-matched, sex-matched, and spherical equivalent-matched control subject. A loss of focal hyperreflectivity, represented by a decrease in the number of hyperreflective dots in the inner choroid, was observed. This finding was assessed for interobserver agreement using five masked observers. Mean observed agreement and multirater kappa statistics (κ) were calculated. The average choroidal thickness was also calculated and compared among acute-phase VKH patients, convalescent-phase VKH patients, and control subjects. RESULTS: There was a significant loss of focal hyperreflectivity in the inner choroid of VKH patients compared with control subjects in both acute and convalescent stages. Analysis revealed substantial interobserver agreement on this finding. The mean observed agreement was 95%, and the overall kappa coefficient (κ) was 0.80 (P < 0.01). The choroid of acute-phase VKH patients was thicker than that of convalescent-phase patients by 151 μm (P = 0.043) and control subjects by 137 μm (P = 0.001). There was no statistically significant difference in thickness between convalescent eyes and controls. CONCLUSION: Enhanced depth imaging spectral-domain OCT highlights a loss of focal hyperreflectivity in the inner choroid of eyes with VKH, a feature that is consistently observed by independent masked observers. The presence of this feature in both acute and convalescent phases could represent permanent structural change to small choroidal vessels caused by VKH uveitis. © The Ophthalmic Communications Society, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/138174
ISSN
2015 Impact Factor: 3.039
2015 SCImago Journal Rankings: 1.912
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorFong, AHCen_HK
dc.contributor.authorLi, KKWen_HK
dc.contributor.authorWong, Den_HK
dc.date.accessioned2011-08-26T14:42:23Z-
dc.date.available2011-08-26T14:42:23Z-
dc.date.issued2011en_HK
dc.identifier.citationRetina, 2011, v. 31 n. 3, p. 502-509en_HK
dc.identifier.issn0275-004Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/138174-
dc.description.abstractBACKGROUND: Current imaging modalities used in the evaluation of Vogt-Koyanagi-Harada (VKH) disease include ultrasound, fluorescein angiogram, indocyanine green angiography, and optical coherence tomography (OCT). However, they all fail to give detailed information on the ultrastructural changes of the choroid. A recent technique using OCT termed "enhanced depth imaging" produces high-resolution cross-sectional images of the whole thickness of the choroid. The purpose of the study was to describe a novel imaging finding in the choroid in cases of VKH uveitis and to assess for interobserver agreement of this new physical sign. METHODS: This is an age-matched, sex-matched, and spherical equivalent-matched, case-control, cross-sectional study. Six VKH patients in acute and convalescent stages underwent choroidal imaging using enhanced depth imaging spectral-domain OCT imaging. A horizontal enhanced depth imaging spectral-domain OCT scan across the fovea was selected for each eye and was compared with a scan from an age-matched, sex-matched, and spherical equivalent-matched control subject. A loss of focal hyperreflectivity, represented by a decrease in the number of hyperreflective dots in the inner choroid, was observed. This finding was assessed for interobserver agreement using five masked observers. Mean observed agreement and multirater kappa statistics (κ) were calculated. The average choroidal thickness was also calculated and compared among acute-phase VKH patients, convalescent-phase VKH patients, and control subjects. RESULTS: There was a significant loss of focal hyperreflectivity in the inner choroid of VKH patients compared with control subjects in both acute and convalescent stages. Analysis revealed substantial interobserver agreement on this finding. The mean observed agreement was 95%, and the overall kappa coefficient (κ) was 0.80 (P < 0.01). The choroid of acute-phase VKH patients was thicker than that of convalescent-phase patients by 151 μm (P = 0.043) and control subjects by 137 μm (P = 0.001). There was no statistically significant difference in thickness between convalescent eyes and controls. CONCLUSION: Enhanced depth imaging spectral-domain OCT highlights a loss of focal hyperreflectivity in the inner choroid of eyes with VKH, a feature that is consistently observed by independent masked observers. The presence of this feature in both acute and convalescent phases could represent permanent structural change to small choroidal vessels caused by VKH uveitis. © The Ophthalmic Communications Society, Inc.en_HK
dc.languageengen_US
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.retinajournal.comen_HK
dc.relation.ispartofRetinaen_HK
dc.subjectchoriocapillarisen_HK
dc.subjectoptical coherence tomographyen_HK
dc.subjectpathologyen_HK
dc.subjectuveomeningoencephalitic syndromeen_HK
dc.subjectVogt-Koyanagi-Harada diseaseen_HK
dc.subject.meshAcute Disease-
dc.subject.meshChoroid - blood supply - pathology-
dc.subject.meshChoroid Diseases - diagnosis-
dc.subject.meshTomography, Optical Coherence-
dc.subject.meshUveomeningoencephalitic Syndrome - diagnosis-
dc.titleChoroidal evaluation using enhanced depth imaging spectral-domain optical coherence tomography in Vogt-Koyanagi-Harada diseaseen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0275-004X&volume=31&issue=3&spage=502&epage=509&date=2011&atitle=Choroidal+evaluation+using+enhanced+depth+imaging+spectral-domain+optical+coherence+tomography+in+Vogt-Koyanagi-Harada+disease-
dc.identifier.emailWong, D: shdwong@hku.hken_HK
dc.identifier.authorityWong, D=rp00516en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1097/IAE.0b013e3182083beben_HK
dc.identifier.pmid21336069-
dc.identifier.scopuseid_2-s2.0-79952290365en_HK
dc.identifier.hkuros191510en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-79952290365&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume31en_HK
dc.identifier.issue3en_HK
dc.identifier.spage502en_HK
dc.identifier.epage509en_HK
dc.identifier.isiWOS:000287472400011-
dc.publisher.placeUnited Statesen_HK
dc.identifier.f10009640956-
dc.identifier.scopusauthoridFong, AHC=12760622100en_HK
dc.identifier.scopusauthoridLi, KKW=7404990010en_HK
dc.identifier.scopusauthoridWong, D=7401536078en_HK

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