Novel fundus fluorescein angiographic findings of bacillary layer detachment in active Vogt-Koyanagi-Harada disease
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Purpose
Describe fundus fluorescein angiography (FFA) features of acute cases of Vogt-Koyanagi-Harada (VKH) disease presenting with bacillary layer detachment (BALAD)
Methods
Retrospective, cross sectional, descriptive, single center analysis was done. FFA imaging of 25 patients ( 47 eyes ) diagnosed to have BALAD secondary to acute VKH was performed. FFA imaging features, its diagnostic utility and prognostic impact were analyzed.
Results
FFA features showed early hypofluorescent areas with pinpoint leakage and late arterio-venous phase hyperfluorescence. BALAD was clinically detected (64.8%) as distinct circumlinear yellow line. Early phase BALAD appeared hypofluorescent on FFA with distinct hypofluorescent line or band like structure corresponding to the clinically seen yellow line. This was present along with inner hyperfluorescence, which was found to be less than that produced by surrounding exudative neurosensory detachments.
Conclusion
FFA can serve as a vital diagnostic tool to determine the presence of BALAD in acute VKH. This study highlights the fact that contrary to belief, BALAD is an FFA active entity, though this activity is less compared to the areas with neurosensory detachment. It will also have potential to serve as a prognostic and therapeutic marker in chronic stage or previously treated cases of VKH.
Conflict of interest
No
1
Last name
JADHAV
Initials of first name(s)
V S
Department
Anant Bajaj Retina Institute and Uveitis Services
City
Visakhapatnam
Country
India
2
Last name
Kelgaonkar
Initials of first name(s)
A N
Department
Anant Bajaj Retina Institute and Uveitis Services
City
Bhubaneswar
Country
India
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