Ocular immunology and inflammation · 2026
Multimodal Imaging Patterns in Chronic, Clinically Inactive Vogt-Koyanagi-Harada Disease.
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Nassisi Marco, Mapelli Chiara, Tripodi Francesco, Casalino Giuseppe, Seregni Luca, Mainetti Claudia, Viola Francesco
Аннотация
PURPOSE: to characterize multimodal imaging patterns in chronic, clinically inactive Vogt-Koyanagi-Harada (VKH) disease and assess their association with clinical parameters, including disease duration and recurrence history.
METHODS: In this retrospective cross-sectional study, 43 eyes from 22 patients with chronic, clinically inactive VKH were evaluated. Inactivity was defined by the absence of active anterior chamber or vitreous inflammation and no funduscopic, tomographic or angiographic signs of ongoing inflammation. All patients underwent multimodal imaging, including fundus autofluorescence (FAF), infrared reflectance (IR), spectral-domain optical coherence tomography (OCT), fluorescein angiography, and indocyanine green angiography. Imaging patterns were assessed by masked observers. Associations with clinical variables were analyzed using logistic regression models with Generalized Estimating Equations to account for inter-eye correlation.
RESULTS: The most frequent findings were a granular FAF pattern (32/43 eyes, 74.4%), peripapillary hypoautofluorescence (30/43 eyes, 69.8%), and IR hyperreflective spots (27/43 eyes, 62.8%). A peripapillary hyperautofluorescent halo was observed in 10 eyes (23.3%). Peripapillary hypoautofluorescence consistently corresponded to outer retinal and RPE atrophy on OCT, whereas IR hyperreflective spots showed limited correspondence with FAF, OCT, or angiographic abnormalities. Longer disease duration was associated with granular FAF pattern (B = 0.515, p = 0.039) and inversely associated with peripapillary hyperautofluorescent halo (B = -0.347, p = 0.030). IR hyperreflective spots were not significantly associated with clinical parameters.
CONCLUSIONS: Multimodal imaging reveals a consistent spectrum of structural alterations in chronic, clinically inactive VKH. Specific FAF patterns were associated with disease duration, suggesting cross-sectional differences compatible with cumulative structural remodeling, without demonstrating longitudinal progression.
METHODS: In this retrospective cross-sectional study, 43 eyes from 22 patients with chronic, clinically inactive VKH were evaluated. Inactivity was defined by the absence of active anterior chamber or vitreous inflammation and no funduscopic, tomographic or angiographic signs of ongoing inflammation. All patients underwent multimodal imaging, including fundus autofluorescence (FAF), infrared reflectance (IR), spectral-domain optical coherence tomography (OCT), fluorescein angiography, and indocyanine green angiography. Imaging patterns were assessed by masked observers. Associations with clinical variables were analyzed using logistic regression models with Generalized Estimating Equations to account for inter-eye correlation.
RESULTS: The most frequent findings were a granular FAF pattern (32/43 eyes, 74.4%), peripapillary hypoautofluorescence (30/43 eyes, 69.8%), and IR hyperreflective spots (27/43 eyes, 62.8%). A peripapillary hyperautofluorescent halo was observed in 10 eyes (23.3%). Peripapillary hypoautofluorescence consistently corresponded to outer retinal and RPE atrophy on OCT, whereas IR hyperreflective spots showed limited correspondence with FAF, OCT, or angiographic abnormalities. Longer disease duration was associated with granular FAF pattern (B = 0.515, p = 0.039) and inversely associated with peripapillary hyperautofluorescent halo (B = -0.347, p = 0.030). IR hyperreflective spots were not significantly associated with clinical parameters.
CONCLUSIONS: Multimodal imaging reveals a consistent spectrum of structural alterations in chronic, clinically inactive VKH. Specific FAF patterns were associated with disease duration, suggesting cross-sectional differences compatible with cumulative structural remodeling, without demonstrating longitudinal progression.