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Early Changes in Ocular Biomarkers in Patients with Vogt-Koyanagi-Harada Disease after Pulse Steroid Therapy
Tetsuya Muto1,2, Shunsuke Kawaguchi1, Shoichiro Kusuda1
1Department of Ophthalmology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan.
Insights
Retinal foveal thickness (RFT) and choroidal foveal thickness (CFT) changes are early indicators in Vogt-Koyanagi-Harada disease. Shallower anterior chamber depth and thicker RFT at baseline predict better visual acuity at one month.
Area of Science:
- Ophthalmology
- Uveitis
- Biomarker Research
Background:
- Vogt-Koyanagi-Harada (VKH) disease is an inflammatory condition affecting ocular tissues.
- Understanding the temporal changes of ocular biomarkers and their correlation with visual acuity is crucial for managing VKH disease.
Purpose of the Study:
- To determine the timing of ocular biomarker changes within one month of treatment.
- To identify which ocular biomarkers correlate with best-corrected visual acuity (BCVA) at one and six months post-treatment.
Main Methods:
- Retrospective analysis of 33 VKH patients treated with pulse steroid therapy.
- Evaluation of anterior-chamber depth (central and peripheral), axial length (AL), BCVA, spherical equivalent (SE), choroidal foveal thickness (CFT), and retinal foveal thickness (RFT).
- Patients were grouped based on BCVA at one and six months to assess correlations with initial ocular biomarkers.
Main Results:
- Significant reductions in RFT and CFT were observed as early as day 1.
- Axial length (AL) showed a significant increase by month 1.
- Best-corrected visual acuity (BCVA) and spherical equivalent (SE) improved significantly within the first week.
- Anterior-chamber biomarkers showed gradual increases, with significant changes noted by week 2 (central ACD) and month 1 (peripheral ACD).
- Better BCVA at month 1 correlated significantly with thicker RFT, better initial BCVA, and shallower central and peripheral anterior chamber depths (ACD).
- No significant correlation was found between initial ocular biomarkers and BCVA at month 6.
Conclusions:
- Retinal foveal thickness (RFT) and choroidal foveal thickness (CFT) are the earliest ocular indicators in VKH disease.
- Anterior-chamber structural changes appear to be slower and delayed compared to RFT and CFT.
- Thicker RFT, better initial BCVA, and shallower anterior chamber depths (central and peripheral) at the initial visit are predictive of better BCVA at one month.
Introduction:
This study aimed to identify when ocular biomarker changes occur within 1 month and which ocular biomarkers correlate with best-corrected visual acuity (BCVA) at months 1 and 6.
Methods:
We evaluated 33 patients with Vogt-Koyanagi-Harada disease who received pulse steroid therapy. The central anterior-chamber depth (ACD) and peripheral ACD were evaluated. We also analyzed axial length (AL), BCVA, spherical equivalent (SE), choroidal foveal thickness (CFT), and retinal foveal thickness (RFT). Patients were divided into two groups based on BCVA at months 1 and 6, and correlations with ocular biomarkers were investigated.
Results:
RFT and CFT were significantly reduced as early as day 1 (p < 0.001). AL gradually increased, with a significant increase observed at month 1 (p < 0.05). BCVA improved significantly along with SE reduction, with significant changes observed at week 1 (p < 0.05 and p < 0.01, respectively). Anterior-chamber biomarkers gradually increased, with significant increases at week 2 for central ACD (p < 0.05) and at month 1 for peripheral ACD (p < 0.05). The better BCVA group at month 1 significantly correlated with thicker RFT (p < 0.01), better BCVA (p < 0.05), shallower central ACD (p < 0.05), and shallower peripheral ACD (p < 0.05) at the initial visit. No correlation was observed between the better BCVA group at month 6 and ocular biomarkers at the initial visit.
Conclusion:
Although RFT and CFT changes are the earliest indicators, changes in the anterior-chamber structure appeared to be slow and delayed. Thicker RFT, better BCVA, shallower central ACD, and shallower peripheral ACD at the initial visit correlated with better BCVA at 1 month.
Introduction:
This study aimed to identify when ocular biomarker changes occur within 1 month and which ocular biomarkers correlate with best-corrected visual acuity (BCVA) at months 1 and 6.
Methods:
We evaluated 33 patients with Vogt-Koyanagi-Harada disease who received pulse steroid therapy. The central anterior-chamber depth (ACD) and peripheral ACD were evaluated. We also analyzed axial length (AL), BCVA, spherical equivalent (SE), choroidal foveal thickness (CFT), and retinal foveal thickness (RFT). Patients were divided into two groups based on BCVA at months 1 and 6, and correlations with ocular biomarkers were investigated.
Results:
RFT and CFT were significantly reduced as early as day 1 (p < 0.001). AL gradually increased, with a significant increase observed at month 1 (p < 0.05). BCVA improved significantly along with SE reduction, with significant changes observed at week 1 (p < 0.05 and p < 0.01, respectively). Anterior-chamber biomarkers gradually increased, with significant increases at week 2 for central ACD (p < 0.05) and at month 1 for peripheral ACD (p < 0.05). The better BCVA group at month 1 significantly correlated with thicker RFT (p < 0.01), better BCVA (p < 0.05), shallower central ACD (p < 0.05), and shallower peripheral ACD (p < 0.05) at the initial visit. No correlation was observed between the better BCVA group at month 6 and ocular biomarkers at the initial visit.
Conclusion:
Although RFT and CFT changes are the earliest indicators, changes in the anterior-chamber structure appeared to be slow and delayed. Thicker RFT, better BCVA, shallower central ACD, and shallower peripheral ACD at the initial visit correlated with better BCVA at 1 month.
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