The Subfoveal Choroidal Thickness Measurement Using Optical Coherence Temography In Diagnoses Of Prodrmal Vogt-Koyanagi-Harada Syndrome

Purpose:The clinical recognition of Vogt-Koyanagi-Harada(VKH)are usually guided by the results of FFA and ICG A as gold standards.Due to the typical changes in the through the implementation of fundus fluorescence angiography(FFA)and indocyanine green angiography(ICGA).The hormone treatments should be applied early once VKH is identified,and a completed course of treatment is required.Due to factors of body responses or conditions such as allergies to the dyes or problems in kidney function,some patients are unable to receive prompt diagnosis,nor early hormone treatment.Hence,the evaluations of the subfoveal choroid thickness is measured by an application of optical coherence temography(OCT)for the studies of accuracy,sensitivity and specificity in the detection of VKH.It may be useful for early clinical diagnoses and treatments.Methods:The outcomes of FFA and ICGA are set as gold standards for the diagnoses of VKH.According to the subfoveal choroidal thickness,which is measured by the application of OCT,and the pre-estimated clinical expectation in accuracy and specificity,the total numbers required for cases and controls can be calculated from the formula of sample size.To gather medical records,measurement of subfoveal choroidal thickness,FFA and ICGA results of VKH patients and patients with other eye diseases,who were treated in the period of 2015/1/1 to 2016/12/31,from Shenyang the Fourth Hospital of People.To invite three associate professional(or professional)clinical doctors who are specialized in diseases of the fundus oculi to either diagnose or exclude VKH based on the medical records,measurement of subfoveal choroidal thickness,FFA and ICGA results in a blind trial,the average(after rounded)results are recorded as-the final numbers of cases and controls.Results:1?If the OCT measurement of choroidal thickness is greater than 500?m,the accuracy of a diagnosis of VKH is 88.10%;2?If the OCT measurement of choroidal thickness is greater than 500?m,the sensitivity of a diagnosis of VKH is 86.52%;3?If the OCT measurement of choroidal thickness is lesser than 300?m,the specificity of an exclusion of VKH is 89.23%;4?If the OCT measurement of choroidal thickness results lesser than 300?m,it is 85.31%confident that the patient is VKH positive;5?If the OCT measurement of choroidal thickness results in negative,it is 90.16%confident that the patient is VKH negative.Conclusion:1?It seems that the accuracy of clinical diagnoses of VKH is high when the OCT measurement of choroidal thickness is greater than 500?m;2?It seems that the sensitivity of clinical diagnoses of VKH is high when,the OCT measurement of choroidal thickness is greater than 500p.m.Hence,with the high positive likelihood ratio and the high confidence in diagnoses of VKH,it is barely to misdiagnose;3?It seems that the specificity of exclusion of VKH is high,and negative likelihood ratio is low,when the OCT measurement of choroidal thickness is lesser than 300?m.Therefore,it is highly confident to exclude VKH,and less likely to misdiagnose.