Novel corneal morphological alterations in Vogt-Koyanagi-Harada disease

Purpose To determine whether visual function, especially when dependent on the anterior segment of ocular tissue, is altered during high-dose steroid treatment for Vogt-Koyanagi-Harada disease (VKH). Study design Retrospective case series Methods This case series included 18 eyes of 18 patients with VKH who received high-dose steroid therapy as initial treatment. All patients underwent anterior swept-source optical coherent tomography (CASIA-2) examinations during their clinical course to measure the central corneal thickness (CCT), average central corneal power (ACCP), maximum curvature (Kmax) and anterior chamber depth (ACD). Results The treatment duration was classified into the initial phase (earliest initial phase eIP; 0–1 month, initial phase: IP; 1–3months), middle phase (MP; 3–6 months), and late phase (LP; 6–9 months). The CCT decreased significantly after treatment (eIP vs. IP, p<0.01, eIP vs. MP, p<0.01; eIP vs. LP, p<0.01). The CCT at eIP was correlated with the flare value at 0M (R 2 =0.22). The change in Kmax at MP and LP was correlated with the flare value at 0M. Moreover, CCT at MP was correlated with rate of change in nasal angle open distance (AOD) at IP and rate of change in temporal AOD at IP. Conclusions This study was the first to reveal morphological changes in the anterior segment of the eye in VKH using CASIA-2, which may affect visual acuity and the astigmatic axis. It is vital to assess corneal morphology to determine the cause of visual function deterioration in patients with VKH.