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Serous detachment of the ciliary body in Harada disease
Y Maruyama1, Y Kimura, S Kishi
1Department of Ophthalmology, Gunma University School of Medicine, Maebashi, Japan. ymaruyam@news.sb.gunma-u.ac.jp
Insights
Harada disease frequently involves ciliary body detachment in the acute phase. This detachment resolves faster than retinal detachment with corticosteroid treatment, potentially causing shallow anterior chambers.
Area of Science:
- Ophthalmology
- Uveitis
- Anterior Segment Imaging
Background:
- Harada disease is a severe, bilateral, idiopathic uveitis affecting the posterior segment.
- Anterior segment involvement in Harada disease is less understood.
- Ultrasound biomicroscopy (UBM) is valuable for evaluating anterior segment structures.
Purpose of the Study:
- To investigate the role of the anterior ocular segment, specifically ciliary body detachment, in Harada disease.
- To assess the impact of systemic corticosteroid therapy on anterior segment findings.
Main Methods:
- Prospective study of 18 eyes from 9 patients with acute Harada disease.
- Ultrasound biomicroscopy (UBM) performed before and during systemic corticosteroid therapy.
- Serial examinations every 3 days until resolution of serous retinal detachment.
Main Results:
- Ciliary body detachment occurred in 61% of eyes before treatment, often involving the circumference.
- Ciliary detachment severity correlated with retinal detachment extent.
- Ciliary detachment resolved by day 3 of treatment in most eyes, preceding retinal detachment resolution.
- Shallow anterior chambers and transient myopia were observed in some patients.
Conclusions:
- Ciliary body detachment is a common finding in acute Harada disease.
- Ciliary detachment responds rapidly to corticosteroid treatment.
- Ciliary detachment may contribute to anterior segment complications like shallow anterior chambers.
Purpose:
To evaluate the involvement of the anterior ocular segment in Harada disease.
Methods:
In a prospective study, ultrasound biomicroscopy was performed in 18 consecutive eyes of nine patients with Harada disease in its acute phase before and after onset of systemic corticosteroid therapy. Examination was repeated every 3 days until the resolution of serous retinal detachment.
Results:
Serous detachment of the ciliary body was present in 11 (61%) of 18 eyes before treatment. The circumference of the ciliary body was detached in 10 of the 11 eyes. The height of ciliary detachment ranged from 20% to 250% of the scleral thickness. Ciliary detachment was more prominent in eyes with more extensive retinal detachment. There was no relation between the frequency of ciliary detachment and the severity of iritis. On day 3 of treatment, ciliary detachment had disappeared in seven eyes. In the other four eyes, it diminished in height to less than 10% of scleral thickness. Retinal detachment disappeared on days 6 through 17 (mean, day 11) of treatment. Two eyes of one patient showed very shallow anterior chambers. These eyes showed high ciliary detachment at 250% of scleral thickness. In another patient, both eyes developed -5.0 diopters of transient myopia.
Conclusion:
Ciliary detachment was a frequent finding in the acute stage of Harada disease. Its resolution was more prompt than that of serous retinal detachment after treatment. Ciliary detachment may be related to the development of a shallow anterior chamber.