Correlation between Microperimetry and Visual Acuity in Patients with Acute Vogt-Koyanagi-Harada Disease receiving Immunosuppressive therapy
Xiu Ling Tan1, Su Ling Ho1
1 National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
To evaluate the effects of immunosuppressive therapy on best-corrected visual acuity (BCVA) and microperimetry in patients with acute Vogt-Koyanagi-Harada disease (VKH).
This was a retrospective observational study. Seven patients with acute VKH were evaluated. Macular sensitivities were measured with the Microperimeter-1 (MP1, Nidek, Japan). Best-corrected visual acuities and mean central 10 degrees retinal sensitivities were assessed at baseline presentation and at 1 week, 1 month and 6 months after treatment.
The mean age was 47.4 years (SD±14.4). 57.1% were female and 86.7% were Chinese. At baseline, the logarithm of the minimum angle of resolution (logMAR) BCVA and mean central 10 degrees retinal sensitivities were 0.80 ± 0.82 and 7.19 ± 7.47 decibels (dB). At 1 week, logMAR BCVA (0.35 ± 0.27) and mean retinal sensitivities (10.19 ± 6.67 dB) improved. At 1 month, logMAR BCVA was 0.13 ± 0.19, and thereafter remained almost unchanged over the subsequent months. However, mean retinal sensitivity continued to improve after 6 months (17.9 ± 1.30dB), but at a slower rate. Mean retinal sensitivity correlated significantly with visual acuity at baseline (p<0.001).
Microperimetry serves as a useful non-invasive adjunct to monitor dynamic retinal changes and effect of immunosuppressive treatment in VKH patients. It may also help to guide tapering of therapy and highlight possible early recurrences in patients whose visual acuities have yet to be affected.