Ultrawidefield Optical Coherence Tomography Angiography in the Mid-Periphery and Macula of Vogt-Koyanagi-Harada Disease.

To investigate ultrawidefield optical coherence tomography angiography (UWF-OCTA) changes in the mid-periphery of new-onset active Vogt-Koyanagi-Harada (VKH) patients. New-onset and untreated active VKH patients were continuously observed using UWF-OCTA at 2 weeks, 1, and 3 months after treatment. Twenty-four new-onset and untreated active VKH patients were included. Seven inactive VKH patients with sunset glow fundus (SGF), and 10 age-sex-matched normal people served as controls. In active VKH patients, there was a significant change in choroidal flow but no change in retinal flow in the mid-periphery before treatment. Vascular density of large- and medium-sized choroidal vessels (LMCV-VD) in mid-periphery, along with retinal and choroidal capillaries in macula, was decreased. Retinal and choroidal thickness in both macula and mid-periphery were increased (all p < 0.05). After 2 weeks of treatment, the parameters of the retina and choroid in both the mid-periphery and the macula were significantly improved. Retinal thickness and LMCV-VD recovered sequentially: first in the macular and temporal regions, followed by the nasal area. Deep capillary plexus-VD in the macula at 3 months of treatment was correlated with visual acuity (r = 0.699, p = 0.002). Binary logistic regression (p = 0.044, OR = 2.695, 95% CI95% CI = 1.027 ~ 7.056) analyses revealed that LMCV-VD at 2 weeks of treatment was associated with the prediction of SGF. In active VKH patients, the parameters of the retina and choroid were altered in both mid-periphery and macula. After treatment, the temporal side was prioritized for recovery. LMCV-VD at two weeks of treatment had the potential to predict the SGF.