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The prognostic value of angiography in Vogt-Koyanagi-Harada disease.

PURPOSE: To determine the prognostic value of fluorescein angiography (FA) and indocyanine green angiography (ICGA) in Vogt-Koyanagi-Harada disease (VKH).

DESIGN: Retrospective noninterventional study.

METHODS: Chart, FA, and ICGA review of VKH patients of Singapore National Eye Centre for age at onset, gender, race, timing of treatment, and angiographic features during the different phases of FA and ICGA. Outcome measure was disease outcome (acute resolved or chronic recurrent).

RESULTS: Twenty-one of the 28 patients with pretreatment FA also had ICGA. Median follow-up duration was 3.6 years (range 0.94-13.42 years). Median age was 42.2 years (range 15.7-77.2 years). The majority (18, 64.3%) were Chinese. The most frequently observed FA features included early pinpoint hyperfluorescence in the posterior pole and disc hyperfluorescence. Large choroidal vessel hyperfluorescence (early and intermediate phase), areas of delayed choroidal perfusion (early phase), and persistent dark dots were the 3 most common ICGA features. Pinpoint peripapillary hyperfluorescence was found to be a significant prognostic FA factor on both univariate and multivariate analysis. None of the ICGA features were found to be significant prognostic factors.

CONCLUSION: Early pinpoint peripapillary hyperfluorescence on pretreatment FA is a useful prognostic sign in VKH patients, whereas pretreatment ICGA has limited prognostic value.

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