Analysis of choroidal folds in acute Vogt-Koyanagi-Harada disease using high-penetration optical coherence tomography.

Objective: To characterize patients with Vogt-Koyanagi-Harada (VKH) disease with choroidal folds (CFs) and determine how the foveal choroidal thickness changes after initial treatment using high-penetration optical coherence tomography (HP-OCT).

Methods: In this retrospective observational study, we analyzed 42 eyes of 21 patients with new-onset VKH disease to determine the demographic and clinical differences between patients with and without CFs.

Results: Twenty-four eyes (57.1 %) of 13 patients with VKH disease had CFs. The mean age (p = 0.0009) of patients with CFs was significantly higher than that of those without CFs (49.1 vs 39.4 years respectively). The frequency of disc swelling (p = 0.0001) was significantly higher in eyes with CFs than in those without CFs (95.8 % vs 38.9 %). The choroidal thickness at the first visit (p = 0.0011) was significantly greater in eyes with CFs than in those without CFs (794 ± 144 μm vs 649 ± 113 μm). The choroid 6 months after the initial treatment (p = 0.0118) was significantly thinner in eyes with CFs than in those without CFs (270 ± 92 μm vs 340 ± 80 μm). The frequency of sunset glow fundus at 6 months (p = 0.0334) in eyes with CFs was significantly higher than in those without CFs (62.5 % vs 27.8 %).

Conclusions: The development of CFs in patients with VKH disease was significantly correlated with age, disc swelling, and choroidal thickness. The eyes with CFs frequently developed a sunset glow fundus. The findings suggested that patients with CFs might have severe and longstanding inflammation of the choroidal tissues.