The changes in optic disc parameters and thickness of circumpapillary retinal nerve fiber layer in acute uveitis of Vogt-Koyanagi-Harada syndrome with different degrees of optic disc edema_Chinese Journal of Ocular Fundus Diseases

Authors：

Pang Yanhua , Yuan Xuehui , Wang Xiuqin , Tan Zhi , Lyu Qiurong , Liu Huaqiong ,  Zhao Guiling

Department of Ophthalmology, Affiliated Hospital of Guangdong Medical College, Zhanjiang 524023, China;

Corresponding author：

Zhao Guiling, Email: zhaoguiling@qq.com

Keywords：

Uveomeningoencephalitic syndrome/complications; Optic disk/physiopathology; Nerve fibers/pathology; Retina/physiopathology; Tomography, optical coherence

DOI：

10.3760/cma.j.issn.1005-1015.2017.05.010

Video：

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Objective To compare the differences of optic disc parameters and the thickness of circumpapillary retinal nerve fiber layer (CP-RNFL) in acute uveitis Vogt-Koyanagi-Harada (VKH) syndrome with different degrees of optic disc edema. Methods This is a retrospective study including 40 eyes of 23 VKH patients. The eyes were divided into 2 groups according to the results of fluorescein fundus angiography (FFA). The discs with hyperfluorescence but no leakage were in mild optic disc edema group (group A, 13 patients and 25 eyes), and the discs with hyperfluorescence and leakage were in severe optic disc edema group (group B, 10 patients and 15 eyes). The patients were significantly older in group B than in group A (t=−2.17, P＜0.05). The differences of gender, diseased time (t=−1.67) and corrected visual acuity (t=−0.76) between 2 groups were not significant (P＞0.05). Eighty eyes of 46 normal healthy subjects, matching group A and group B with age and gender, were divided into group C (26 subjects and 50 eyes) and group D (20 subjects and 30 eyes) respectively. All subjects underwent three dimensional optical coherence tomography examinations. The parameters included average thickness of entire circumpapillary retinal nerve fiber layer (CP-RNFL), thickness of nasal, superior, temporal and inferior quadrant of CP-RNFL, disc area, disc cup area, rim area, cup/disc (C/D) area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio. Results The disc area, disc cup area and rim area were bigger, the thickness of mean CP-RNFL and the nasal and temporal quadrants of CP-RNFL were thicker in group A than those in group C (P＜0.05). The disc area and rim area were bigger, the thickness of mean CP-RNFL and the nasal, superior, temporal and inferior quadrant of CP-RNFL were thicker, C/D area ratio and C/D diameter ratio were smaller in group B than those in group D (P＜0.05). The disc area was bigger, disc cup area, C/D area ratio and C/D diameter ratio were smaller, the thickness of mean CP-RNFL and the nasal , superior and inferior quadrants of CP-RNFL were thicker in group B than those in group A (P＜0.05). Conclusions Acute VKH uveitis with mild optic disc edema has thicker CP-RNFL in the nasal and temporal quadrants; with severe optic disc edema has thicker CP-RNFL in all 4 quadrants. Acute VKH uveitis also has smaller C/D area ratio and C/D diameter ratio.

Citation： Pang Yanhua, Yuan Xuehui, Wang Xiuqin, Tan Zhi, Lyu Qiurong, Liu Huaqiong, Zhao Guiling. The changes in optic disc parameters and thickness of circumpapillary retinal nerve fiber layer in acute uveitis of Vogt-Koyanagi-Harada syndrome with different degrees of optic disc edema. Chinese Journal of Ocular Fundus Diseases, 2017, 33(5): 481-484. doi: 10.3760/cma.j.issn.1005-1015.2017.05.010 Copy

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2.	Menke MN, Feke GT, Trempe CL. OCT measurements in patients with optic disc edema [J]. Invest Ophthalmol Vis Sci, 2005, 46(10): 3807-3811. DOI: 10.1167/iovs.05-0352.
3.	Scott CJ, Kardon RH, Lee AG, et al. Diagnosis and grading of papilledema in patients with raised intracranial pressure using optical coherence tomography vs clinical expert assessment using a clinical staging scale[J]. Arch Ophthalmol, 2010, 128(6): 705-711. DOI: 10.1001/archophthalmol.2010.94.
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6.	Sakata VM, da Silva FT, Hirata CE, et al. Diagnosis and classification of Vogt-Koyanagi-Harada disease[J]. Autoimmun Rev, 2014, 13(45): 550-555. DOI: 10.1016/j.autrev.2014.01.023.
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8.	赵桂玲, 陈剑, 庞燕华, 等.3D OCT研究近视眼RNFL厚度及视盘参数[J]. 中国实用眼科杂志, 2014, 32(3): 282-285. DOI: 10.3760/cma.j.issn.1006-4443.2014.03.007.Zhao GL, Chen J, Pang YH, et al. Analysis on thickness of retinal nerve fiber layer and optic nerve head parameters in myopia by using optical coherence tomography[J]. Chin J Pract Ophthalmol, 2014, 32(3): 282-285. DOI: 10.3760/cma.j.issn.1006-4443.2014.03.007.
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11.	Okunuki Y, Tsubota K, Kezuka T, et al. Differences in the clinical features of two types of Vogt-Koyanagi-Harada disease: serous retinal detachment and optic disc swelling[J]. J Ophthalmol, 2015, 59(2): 103-108. DOI: 10.1007/s10384-014-0367-8.

1. Nakao K, Abematsu N, Mizushima Y, et al. Optic disc swelling in Vogt-Koyanagi-Harada disease[J]. Invest Ophthalmol Vis Sci, 2012, 53(4): 1917-1922. DOI: 10.1167/iovs.11-8984.
2. Menke MN, Feke GT, Trempe CL. OCT measurements in patients with optic disc edema [J]. Invest Ophthalmol Vis Sci, 2005, 46(10): 3807-3811. DOI: 10.1167/iovs.05-0352.
3. Scott CJ, Kardon RH, Lee AG, et al. Diagnosis and grading of papilledema in patients with raised intracranial pressure using optical coherence tomography vs clinical expert assessment using a clinical staging scale[J]. Arch Ophthalmol, 2010, 128(6): 705-711. DOI: 10.1001/archophthalmol.2010.94.
4. Rebolleda G, Munoz-Negrete FJ. Follow-up of mild papilledema in idiopathic intracranial hypertension with optical coherence tomography[J]. Invest Ophthalmol Vis Sci, 2009, 50(11): 5197-5200. DOI: 10.1167/iovs.08-2528.
5. Regatieri CV, Alwassia A, Zhang JY. Use of optical coherence tomography in the diagnosis and management of uveitis [J]. Int Ophthalmol Clin, 2012, 52(4): 33-43. DOI: 10.1097/IIO.0b013e318265d439.
6. Sakata VM, da Silva FT, Hirata CE, et al. Diagnosis and classification of Vogt-Koyanagi-Harada disease[J]. Autoimmun Rev, 2014, 13(45): 550-555. DOI: 10.1016/j.autrev.2014.01.023.
7. Celebi AR, Mirza GE. Age-related change in retinal nerve fiber layer thickness measured with spectral domain optical coherence tomography [J]. Invest Ophthalmol Vis Sci, 2013, 54(13): 8095-8103. DOI: 0.1167/iovs.13-12634.
8. 赵桂玲, 陈剑, 庞燕华, 等.3D OCT研究近视眼RNFL厚度及视盘参数[J]. 中国实用眼科杂志, 2014, 32(3): 282-285. DOI: 10.3760/cma.j.issn.1006-4443.2014.03.007.Zhao GL, Chen J, Pang YH, et al. Analysis on thickness of retinal nerve fiber layer and optic nerve head parameters in myopia by using optical coherence tomography[J]. Chin J Pract Ophthalmol, 2014, 32(3): 282-285. DOI: 10.3760/cma.j.issn.1006-4443.2014.03.007.
9. 劳远琇, 钟勇, 赖宗白.视神经疾病[M]//张承芬.眼底病学. 2版. 北京: 人民卫生出版社, 2010: 577-579.Lao YX, Zhong Y, Lai ZB. Optic nerve diseases[M]//Zhang CF. Diseases of ocular fundus. 2nd ed. Beijing: People's Medical Publishing House, 2010: 577-579.
10. Sani RY, Abdu L, Pam V. Retinal nerve fiber layer thickness measurements of normal Northern Nigerian adults using optical coherence tomography[J]. Ann Afr Med, 2016, 15(2): 52-57. DOI: 10.4103/1596-3519.172557.
11. Okunuki Y, Tsubota K, Kezuka T, et al. Differences in the clinical features of two types of Vogt-Koyanagi-Harada disease: serous retinal detachment and optic disc swelling[J]. J Ophthalmol, 2015, 59(2): 103-108. DOI: 10.1007/s10384-014-0367-8.

Chinese Journal of Ocular Fundus Diseases

The changes in optic disc parameters and thickness of circumpapillary retinal nerve fiber layer in acute uveitis of Vogt-Koyanagi-Harada syndrome with different degrees of optic disc edema

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