Spectral-Domain Cirrus Optical Coherence Tomography of Choroidal Striations Seen in the Acute Stage of Vogt-Koyanagi-Harada Disease

PURPOSE: To describe changes in the retinal pigment epithelium (RPE) corresponding to the choroidal striations in acute-stage Vogt-Koyanagi-Harada (VKH) disease. DESIGN: Prospective, consecutive case series. METHODS: Four patients (eight eyes) with acute-stage VKH disease were studied. All underwent fundus fluorescein angiography (FFA), ultrasonography, and spectral-domain optical coherence tomography (SD OCT). The main outcome measure was the correlation of the findings seen on a 3-dimensional (3D) single-layer RPE map constructed on SD OCT with the serous retinal detachment (RD) and choroidal striations. RESULTS: The retina inner to external limiting membrane did not show any structural alteration in any of the eyes. The 3D single-layer RPE map showed undulations and bumps on the RPE surface in all the eyes. The troughs of the undulations were noted to correspond to the choroidal striations seen as hypofluorescent lines in the early phase of FFA. The bumps over the undulations corresponded to the pinpoint hyperfluorescent dots on FFA, resulting in the development of serous RDs over the troughs, thus obscuring the hypofluorescent lines in the late phase of fluorescein angiograms. CONCLUSIONS: The troughs of the RPE undulations were seen clinically as choroidal striations in the acute uveitic stage of VKH disease. (Am J Ophthalmol 2009;147:148-153. (c) 2009 by Elsevier Inc. All rights reserved.)