Background: To investigate indocyanine green angiography (ICGA) findings in patients with long-standing\r\nVogt-Koyanagi-Harada (VKH) disease and their correlation with disease activity on clinical examination as well as\r\nwith systemic corticosteroid therapy.\r\nMethods: Twenty-eight patients (51 eyes) with long-standing (=6 months from disease onset) VKH disease whose\r\ntreatment was tapered based only in clinical features were prospectively included at a single center in Brazil. All\r\npatients underwent standardized clinical evaluation, which included fundus photography, fluorescein angiography\r\nand ICGA. Clinical disease activity was determined based in the Standardization in Uveitis Nomenclature Working\r\nGroup. Fisher exact test and logistic regression models were used for statistical analysis.\r\nResults: Disease-related choroidal inflammation on ICGA was observed in 72.5% (31 of 51 eyes). Angiographic\r\nfindings suggestive of (choroidal and/or retinal) disease activity were not observed on FA. Clinically active disease\r\nbased on clinical evaluation was observed in 41.2% (21 of 51 eyes). In these 21 eyes, disease-related choroidal\r\ninflammation on ICGA was observed in 76.2% (16 of 21 eyes); in the remaining eyes (without clinical active disease)\r\ndisease-related choroidal inflammation on ICGA was observed in 70.0% (21 of 30 eyes). In respect to systemic\r\ncorticosteroid therapy, 10 patients (18 of 51 eyes) were under treatment with prednisone. In these 10 (18 of 51\r\neyes) patients, disease-related choroidal inflammation on ICGA was observed in 83.3% (15 of 18 eyes); in the\r\nremaining patients (33 of 51 eyes) disease-related choroidal inflammation on ICGA was observed in 66.7%\r\n(22 of 33 eyes).\r\nConclusion: ICGA findings suggestive of disease-related choroidal inflammation were observed in a considerable\r\nproportion of patients with long-standing VKH disease, independent of the inflammatory status of the disease on\r\nclinical examination or current use of systemic corticosteroid. Therefore, the current study reinforces the crucial role\r\nof ICGA to assist the management and treatment of patients with long-standing VKH disease.
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