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Tomographic features of serous retinal detachment with multilobular dye pooling in acute Vogt-Koyanagi-Harada disease
Yumiko Yamaguchi1, Tomohiro Otani, Shoji Kishi
1Department of Ophthalmology, Gunma University School of Medicine, Maebashi, Gunma, Japan. yamame@showa.gunma-u.ac.jp
Purpose:
To clarify the morphologic background of serous retinal detachment with multilobular dye pooling on fluorescein angiography (FA) in acute Vogt-Koyanagi-Harada (VKH) disease.
Design:
Retrospective uncontrolled case series.
Methods:
setting: Institutional study. study population: Ten eyes of five patients aged 16 to 52 years (average age, 31 years) with VKH disease who presented with a serous retinal detachment. observation procedures: Clinical examination and optical coherence tomography (OCT). main outcome measures: Findings on OCT and FA.
Results:
All eyes had multilobular dye pooling with a dark rim on late-phase FA. OCT revealed subretinal septa that divided the subretinal space into several compartments. The subretinal septum lay on the retinal pigment epithelium (RPE) in the foveal area, forming the posterior wall of the subfoveal compartment while it detached from the RPE in the perifoveal area, which served as a lateral wall between the subfoveal and perifoveal compartments. The dark rims of each area of subretinal dye pooling corresponded to the subretinal septa. Soon after steroid pulse therapy, the subretinal septa resolved completely in all eyes.
Conclusion:
Subretinal septa caused multilobular dye pooling in serous retinal detachment associated with acute VKH disease. We assume that the subretinal septa are comprised of inflammatory products such as fibrin, which immediately resolve after steroid pulse therapy.
