Analysis of choroidal folds in acute Vogt‐Koyanagi‐Harada disease using high‐ penetration optical coherence tomography

Purpose To characterize patients with Vogt‐Koyanagi‐Harada (VKH) disease with choroidal folds (CFs) and determine how the foveal choroidal thickness changes after initial treatment using high‐penetration optical coherence tomography (HP‐OCT). Methods In this retrospective observational study, we analyzed 42 eyes of 21 patients with new‐onset VKH disease to determine the demographic and clinical differences between patients with and without CFs. Results Twenty‐four (57.1%) eyes of 13 patients with VKH disease had CFs. The mean age of patients with CFs was significantly (p = 0.0009) higher than that of those without CFs (49.1 vs. 39.4 years, respectively). The frequency of disc swelling was significantly (p = 0.0001) higher in eyes with CFs than in those without CFs (95.8 vs. 38.9%). The choroidal thickness at the first visit was significantly (p = 0.0011) greater in eyes with CFs than in those without CFs (794 ± 144 μm vs. 649 ± 113 μm). The choroid 6 months after the initial treatment was significantly (p = 0.0118) thinner in eyes with CFs than in those without CFs (270 ± 92 μm vs. 340 ± 80 μm). The frequency of sunset glow fundus at 6 months in eyes with CFs was significantly (p = 0.0334) higher than in those without CFs (62.5 vs. 27.8%). Conclusions The development of CFs in patients with VKH disease was significantly correlated with age, disc swelling, and choroidal thickness. The eyes with CFs frequently developed a sunset glow fundus. The findings suggested that patients with CFs might have severe and longstanding inflammation of choroidal tissues.