Early Changes in Ocular Biomarkers in Patients with Vogt-Koyanagi-Harada Disease After Pulse Steroid Therapy.

Introduction: This study aimed to identify when ocular biomarker changes occur within 1 month and which ocular biomarkers correlate with best-corrected visual acuity (BCVA) at months 1 and 6.

Methods: We evaluated 33 patients with Vogt-Koyanagi-Harada (VKH) disease who received pulse steroid therapy. The central anterior-chamber depth (ACD) and peripheral ACD were evaluated. We also analyzed axial length (AL), BCVA, spherical equivalent (SE), choroidal foveal thickness (CFT), and retinal foveal thickness (RFT). Patients were divided into two groups based on BCVA at months 1 and 6, and correlations with ocular biomarkers were investigated.

Results: RFT and CFT were significantly reduced as early as day 1 (P < 0.001). AL gradually increased, with a significant increase observed at month 1 (P < 0.05). BCVA improved significantly along with SE reduction, with significant changes observed at week 1 (P < 0.05 and P < 0.01, respectively). Anterior chamber biomarkers gradually increased, with significant increases at week 2 for central ACD (P < 0.05) and at month 1 for peripheral ACD (P < 0.05). The better BCVA group at month 1 significantly correlated with thicker RFT (P < 0.01), better BCVA (P < 0.05), shallower central ACD (P < 0.05), and shallower peripheral ACD (P < 0.05) at the initial visit. No correlation was observed between the better BCVA group at month 6 and ocular biomarkers at the initial visit.

Conclusion: Although RFT and CFT changes are the earliest indicators, changes in the anterior-chamber structure appeared to be slow and delayed. Thicker RFT, better BCVA, shallower central ACD, and shallower peripheral ACD at the initial visit correlated with better BCVA at 1 month.