Correlation Between Hyperreflective Foci in the Choroid and Choroidal Discoloration in Vogt-Koyanagi-Harada Disease

PURPOSE: To investigate the distribution of hyperreflective choroidal foci (HCF) in eyes with Vogt-Koyanagi-Harada (VKH) disease. METHODS: We included 22 eyes of 11 patients with VKH disease in the convalescent stages and 22 eyes of age- and sex-matched normal controls. HCF were quantified using en face optical coherence tomography (OCT) images of the choroid, and the degree of fundus pigmentation was determined by the color balance of the fundus photographs. The results were then analyzed between the eyes with and without sunset glow fundus (SGF). RESULTS: The median age of patients with VKH disease was 58.0 (range 54.0–65.0) years, and median disease duration was 66.4 (range 8.5–147.7) months. In 22 eyes with VKH, the number and total area of HCF were correlated with the degree of fundus pigmentation (ρ = −0.671, P < 0.001; ρ = −0.612, P = 0.002, respectively). The number of HCF was significantly smaller in VKH disease–affected eyes with SGF (median, interquartile range; 134.6, 110.0–159.2) than in those without SGF (229.0, 197.0–261.0) and the eyes of normal controls (211.8, 190.3–233.4). CONCLUSIONS: HCF distributions correlated with the degree of fundus pigmentation in eyes with VKH disease. Quantitative measurements of HCF on en face OCT images can be a novel tool in evaluating choroidal pigmentation in patients with VKH disease.