Changes in scleral thickness in the acute phase of Vogt-Koyanagi-Harada disease

Purpose: To evaluate changes in scleral thickness in Vogt-Koyanagi-Harada (VKH) disease. Methods: This study included 34 eyes of 17 treatment-naïve patients with acute-phase VKH disease. Scleral thickness and the presence of ciliochoroidal effusion (CE) were examined using anterior segment optical coherence tomography at baseline and 1, 2, and 12 weeks after the start of corticosteroid treatment. Scleral thickness was measured 6 mm posterior to the scleral spur in four directions. Results: Twenty-eight eyes (82.4%) initially had CE, but this rapidly decreased to nine eyes (26.5%) after 1 week. The sclera with CE became thinner from baseline to 1 week at the superior (400.2 ± 46.9 to 353.5 ± 47.9 μm), temporal (428.4 ± 53.6 to 387.8 ± 56.1 μm), inferior (451.5 ± 71.0 to 400.5 ± 50.5 μm), and nasal (452.4 ± 78.0 to 407.6 ± 62.9 μm) points (P < 0.01 for all) and no further changes were observed. The sclera without CE remained unchanged. Conclusion: In VKH disease, eyes with CE exhibited the maximum scleral thickness during the acute phase. This thickening responded rapidly to treatment and became thinner within 1 week. Inflammation in VKH disease may affect not only the choroid but also the sclera.