The changes in optic disc parameters of Vogt-Koyanagi-Harada syndrome and optic neuritis with optic disc edema using three-dimensional optical coherence tomography_Chinese Journal of Ocular Fundus Diseases

Authors：

Pang Yanhua , Tan Zhi , Wang Xiuqin , Liang Demao ,  Zhao Guiling

Department of Ophthalmology, Affiliated Hospital of Guangdong Medical College, Zhanjiang 524023, China;

Corresponding author：

Zhao Guiling, Email: zhaoguiling@qq.com

Keywords：

Uveomeningoencephalitic syndrome/complications; Optic neuritis/diagnosis; Optic disk/physiopathology; Nerve fibers/pathology; Retina/physiopathology; Tomography, optical coherence

DOI：

10.3760/cma.j.issn.1005-1015.2017.05.009

Video：

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Objective To compare the differences of optic disc morphology and optic nerve head parameters between Vogt-Koyanagi-Harada (VKH) syndrome and optic neuritis (ON) with optic disc edema. Methods This is a retrospective study including 21 first-onset VKH patients (35 eyes) as VKH group and 22 first-onset ON patients with optic disc edema (27 eyes) as ON group. The differences of age (t=−1.11) and gender (χ²=0.20) between two groups were not significant (P＞0.05). Sixty-two eyes of 43 age and gender-matched healthy subjects were enrolled in this study as control group. All subjects underwent three dimensional optical coherence tomography (3D-OCT) examinations. The difference of optic disc morphology between two groups was observed. The parameters included average thickness of entire circumpapillary retinal nerve fiber layer (CP-RNFL), thickness of nasal, superior, temporal and inferior quadrant of CP-RNFL, disc area, disc cup area, rim area, cup/disc (C/D) area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio. The disc retinal pigment epithelium (RPE) angle was observed too. Results Among 35 eyes in VKH group, 31 eyes (88.57%) had retinal detachment next to the disc, 3 eyes (8.57%) had serrated inner limiting membranes of the disc. Twenty eyes (64.52%) had highly reflective points, lines, or membrane-like structures in the retinal detachment areas. No such signs appeared in ON patients. Compared with ON group, the optic cup area, C/D area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio were bigger, the thickness of mean CP-RNFL and the superior, inferior quadrants of CP-RNFL were thinner, disc RPE angles was smaller in VKH group (P＜0.05). Compared with control group, the disc area, optic cup area, rim area were bigger, C/D vertical diameter ratio was smaller, the mean CP-RNFL and 4 quadrants CP-RNFL were thicker, disc RPE angles was smaller in VKH group (P＜0.05); the disc area, optic cup area, C/D area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio were smaller, the mean CP-RNFL and 4 quadrants CP-RNFL were thicker, disc RPE angles was bigger in VKH group (P＜0.05). Conclusions VKH patients have smaller disc RPE angles and more chance to develop retinal detachment next to disc than ON patients. The C/D area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio are bigger, the mean CP-RNFL and the superior, inferior quadrants of CP-RNFL are thinner in VKH eyes.

Citation： Pang Yanhua, Tan Zhi, Wang Xiuqin, Liang Demao, Zhao Guiling. The changes in optic disc parameters of Vogt-Koyanagi-Harada syndrome and optic neuritis with optic disc edema using three-dimensional optical coherence tomography. Chinese Journal of Ocular Fundus Diseases, 2017, 33(5): 476-480. doi: 10.3760/cma.j.issn.1005-1015.2017.05.009 Copy

1.	O'Keefe GA, Rao NA. Vogt-Koyanagi-Harada disease[J]. Surv Ophthalmol, 2017, 62(1): 1-25. DOI: 10.1016/j.survophthal.2016.05.002.
2.	Maruko I, Iida T, Sugano Y, et al. Subfoveal choroidal thickness in papillitis type of Vogt-Koyanagi-Harada disease and idiopathic optic neuritis[J]. Retina, 2016, 36(5): 992-999. DOI: 10.1097/IAE.0000000000000816.
3.	Toosy AT, Mason DF, Miller DH. Optic neuritis[J]. Lancet Neurol, 2014, 13(1): 83-99. DOI: 10.1016/S1474-4422(13)70259-X.
4.	Rajendram R, Evans M, Khurana RN, et al. Vogt-Koyanagi-Harada disease presenting as optic neuritis[J]. Int Ophthalmol, 2007, 27(2-3): 217-220. DOI: 10.1007/s10792-006-9026-5.
5.	Shin KS, Han YS, Kim MS, et al. Changes of central macular thickness and retinal nerve fiber layer thickness in eyes with Vogt-Koyanagi-Harada disease: a 2-yearfollow-up study[J]. Acta Ophthalmologica, 2016, 96(256): 4-10. DOI: 10.1111/j.1755-3768.2016.0431.
6.	Gabilondo I, Martínez-Lapiscina EH, Fraga-Pumar E, et al. Dynamics of retinal injury after acute optic neuritis[J]. Ann Neurol, 2015, 77(3): 517-528. DOI: 10.1002/ana.24351.
7.	Kupersmith MJ, Sibony P, Mandel G, et al. Optical coherence tomography of the swollen optic nerve head: deformation of the peripapillary retinal pigment epithelium layer in papilledema[J]. Invest Ophthalmol Vis Sci, 2011, 52(9): 6558-6564. DOI: 10.1167/iovs.10-6782.
8.	Sakata VM, da Silva FT, Hirata CE, et al. Diagnosis and classification of Vogt-Koyanagi-Harada disease[J]. Autoimmun Rev, 2014, 13(4-5): 550-555. DOI: 10.1016/j.autrev.2014.01.023.
9.	中华医学会眼科学分会神经眼科学组.视神经炎诊断和治疗专家共识(2014年)[J]. 中华眼科杂志, 2014, 50(6): 459-462. DOI: 10.3760/cma.j.issn.0412-4081.2014.06.013.Neuro-Ophthalmology Group, Ophthalmology Branch of Chinese Medical Association. Diagnosis and treatment guideline of optic neuritis (2014)[J]. Chin J Ophthalmol, 2014, 50(6): 459-462. DOI: 10.3760/cma.j.issn.0412-4081.2014.06.013.
10.	郭娅玲, 何剑峰.伏格特-小柳-原田病的病理学特点[J]. 眼科研究, 2009, 27(9): 830-832. DOI: 10.3760/cma.j.issn.2095-0160.2009.09.022.Guo YL, He JF. Pathology features of Vogt-Koyanagi-Harada disease[J]. Chin Ophthal Res, 2009, 27(9): 830-832. DOI: 10.3760/cma.j.issn.2095-0160.2009.09.022.
11.	Agrawal R, Li LK, Nakhate V, et al. Choroidal vascularity index in Vogt-Koyanagi-Harada disease: an EDI-OCT derived tool for monitoring disease progression[J]. Transl Vis Sci Technol, 2016, 5(4): 7. DOI: 10.1167/tvst.5.4.7.
12.	马南南, 丛春霞, 李立, 等. 增强深度成像OCT对急性期视神经炎患者早期视网膜和脉络膜变化的定量评估[J]. 中华实验眼科杂志, 2017, 35(1): 47-52. DOI: 10.3760/cma.j.issn.2095-0160.2017.01.010.Ma NN, Cong CX, Li L, et al. Quantitative assessment of retinal and choroidal changes by enhanced depth imaging OCT in acute optic neuritis patients[J]. Chin J Exp Ophthalmol, 2017, 35(1): 47-52. DOI: 10.3760/cma.j.issn.2095-0160.2017.01.010.
13.	Yamamoto M, Nishijima K, Nakamura M, et al. Inner retinal changes in acute-phase Vogt-Koyanagi-Harada disease measured by enhanced spectral domain optical coherence tomography[J]. Jpn J Ophthalmol, 2011, 55(1): 1-6. DOI: 10.1007/s10384-010-0900-3.
14.	Lee JE, Park SW, Lee JK, et al. Edema of the photoreceptor layer in Vogt-Koyanagi-Harada disease observed using high-resolution optical coherence tomography[J]. Korean J Ophthalmol, 2009, 23(2): 74-79. DOI: 10.3341/kjo.2009.23.2.74.
15.	Nakao K, Abematsu N, Mizushima Y, et al. Optic disc swelling in Vogt-Koyanagi-Harada disease[J]. Invest Ophthalmol Vis Sci, 2012, 53(4): 1917-1922. DOI: 10.1167/iovs.11-8984.
16.	Gabilondo I, Martínez-Lapiscina EH, Fraga-Pumar E, et al. Dynamics of retinal injury after acute optic neuritis[J]. Ann Neurol, 2015, 77(3): 517-528. DOI: 10.1002/ana.24351.
17.	Lin D, Chen W, Zhang G, et al. Comparison of the optical coherence tomographic characters between acute Vogt-Koyanagi-Harada disease and acute central serous chorioretinopathy[J]. BMC Ophthalmol, 2014, 14: 87. DOI: 10.1186/1471-2415-14-87.

1. O'Keefe GA, Rao NA. Vogt-Koyanagi-Harada disease[J]. Surv Ophthalmol, 2017, 62(1): 1-25. DOI: 10.1016/j.survophthal.2016.05.002.
2. Maruko I, Iida T, Sugano Y, et al. Subfoveal choroidal thickness in papillitis type of Vogt-Koyanagi-Harada disease and idiopathic optic neuritis[J]. Retina, 2016, 36(5): 992-999. DOI: 10.1097/IAE.0000000000000816.
3. Toosy AT, Mason DF, Miller DH. Optic neuritis[J]. Lancet Neurol, 2014, 13(1): 83-99. DOI: 10.1016/S1474-4422(13)70259-X.
4. Rajendram R, Evans M, Khurana RN, et al. Vogt-Koyanagi-Harada disease presenting as optic neuritis[J]. Int Ophthalmol, 2007, 27(2-3): 217-220. DOI: 10.1007/s10792-006-9026-5.
5. Shin KS, Han YS, Kim MS, et al. Changes of central macular thickness and retinal nerve fiber layer thickness in eyes with Vogt-Koyanagi-Harada disease: a 2-yearfollow-up study[J]. Acta Ophthalmologica, 2016, 96(256): 4-10. DOI: 10.1111/j.1755-3768.2016.0431.
6. Gabilondo I, Martínez-Lapiscina EH, Fraga-Pumar E, et al. Dynamics of retinal injury after acute optic neuritis[J]. Ann Neurol, 2015, 77(3): 517-528. DOI: 10.1002/ana.24351.
7. Kupersmith MJ, Sibony P, Mandel G, et al. Optical coherence tomography of the swollen optic nerve head: deformation of the peripapillary retinal pigment epithelium layer in papilledema[J]. Invest Ophthalmol Vis Sci, 2011, 52(9): 6558-6564. DOI: 10.1167/iovs.10-6782.
8. Sakata VM, da Silva FT, Hirata CE, et al. Diagnosis and classification of Vogt-Koyanagi-Harada disease[J]. Autoimmun Rev, 2014, 13(4-5): 550-555. DOI: 10.1016/j.autrev.2014.01.023.
9. 中华医学会眼科学分会神经眼科学组.视神经炎诊断和治疗专家共识(2014年)[J]. 中华眼科杂志, 2014, 50(6): 459-462. DOI: 10.3760/cma.j.issn.0412-4081.2014.06.013.Neuro-Ophthalmology Group, Ophthalmology Branch of Chinese Medical Association. Diagnosis and treatment guideline of optic neuritis (2014)[J]. Chin J Ophthalmol, 2014, 50(6): 459-462. DOI: 10.3760/cma.j.issn.0412-4081.2014.06.013.
10. 郭娅玲, 何剑峰.伏格特-小柳-原田病的病理学特点[J]. 眼科研究, 2009, 27(9): 830-832. DOI: 10.3760/cma.j.issn.2095-0160.2009.09.022.Guo YL, He JF. Pathology features of Vogt-Koyanagi-Harada disease[J]. Chin Ophthal Res, 2009, 27(9): 830-832. DOI: 10.3760/cma.j.issn.2095-0160.2009.09.022.
11. Agrawal R, Li LK, Nakhate V, et al. Choroidal vascularity index in Vogt-Koyanagi-Harada disease: an EDI-OCT derived tool for monitoring disease progression[J]. Transl Vis Sci Technol, 2016, 5(4): 7. DOI: 10.1167/tvst.5.4.7.
12. 马南南, 丛春霞, 李立, 等. 增强深度成像OCT对急性期视神经炎患者早期视网膜和脉络膜变化的定量评估[J]. 中华实验眼科杂志, 2017, 35(1): 47-52. DOI: 10.3760/cma.j.issn.2095-0160.2017.01.010.Ma NN, Cong CX, Li L, et al. Quantitative assessment of retinal and choroidal changes by enhanced depth imaging OCT in acute optic neuritis patients[J]. Chin J Exp Ophthalmol, 2017, 35(1): 47-52. DOI: 10.3760/cma.j.issn.2095-0160.2017.01.010.
13. Yamamoto M, Nishijima K, Nakamura M, et al. Inner retinal changes in acute-phase Vogt-Koyanagi-Harada disease measured by enhanced spectral domain optical coherence tomography[J]. Jpn J Ophthalmol, 2011, 55(1): 1-6. DOI: 10.1007/s10384-010-0900-3.
14. Lee JE, Park SW, Lee JK, et al. Edema of the photoreceptor layer in Vogt-Koyanagi-Harada disease observed using high-resolution optical coherence tomography[J]. Korean J Ophthalmol, 2009, 23(2): 74-79. DOI: 10.3341/kjo.2009.23.2.74.
15. Nakao K, Abematsu N, Mizushima Y, et al. Optic disc swelling in Vogt-Koyanagi-Harada disease[J]. Invest Ophthalmol Vis Sci, 2012, 53(4): 1917-1922. DOI: 10.1167/iovs.11-8984.
16. Gabilondo I, Martínez-Lapiscina EH, Fraga-Pumar E, et al. Dynamics of retinal injury after acute optic neuritis[J]. Ann Neurol, 2015, 77(3): 517-528. DOI: 10.1002/ana.24351.
17. Lin D, Chen W, Zhang G, et al. Comparison of the optical coherence tomographic characters between acute Vogt-Koyanagi-Harada disease and acute central serous chorioretinopathy[J]. BMC Ophthalmol, 2014, 14: 87. DOI: 10.1186/1471-2415-14-87.

Chinese Journal of Ocular Fundus Diseases

The changes in optic disc parameters of Vogt-Koyanagi-Harada syndrome and optic neuritis with optic disc edema using three-dimensional optical coherence tomography

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