Clinical course of focal choroidal excavation in Vogt–Koyanagi–Harada disease

Yuko Nishikawa,1–3,* Kaoru Fujinami,1,2,4,5,* Ken Watanabe,1,2 Toru Noda,1,2 Kazushige Tsunoda,1,2 Kunihiko Akiyama1,2 1Department of Ophthalmology, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan; 2Laboratory of Visual Physiology, National Institute of Sensory Organs, National Tokyo Medical Center, Tokyo, Japan; 3Department of Ophthalmology, Osaka Medical College, Takatsuki, Osaka, Japan; 4Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan; 5UCL Institute of Ophthalmology, London, UK*These authors contributed equally to this workAbstract: We describe focal choroidal excavation (FCE) in a case of Vogt–Koyanagi–Harada (VKH) disease and compare the findings with different chorioretinal conditions. A 55-year-old man was diagnosed with VKH based on panuveitis and exudative retinal detachments. Spectral-domain optical coherence tomography demonstrated a dome-shaped protrusion with a nonconforming pattern at the fovea, which had been detected as a conforming pattern 1 year before the onset. The FCE pattern returned into a conforming pattern following corticosteroid therapy. These findings suggest that the natively existent FCE could be affected by pathophysiological changes of VKH as well as other chorioretinal conditions.Keywords: choroidal excavation, focal choroidal excavation, Vogt–Koyanagi–Harada disease, optical coherence tomography