Retina-Vitreous
2012 , Vol 20 , Num 3
Vogt-Koyanagi-Harada Syndrome: A Retrospective Case Series
1M.D., Dokuz Eylül University Faculty of Medicine, Department of Ophthalmology, İzmir/TURKEY2M.D. Asistant, Dokuz Eylül University Faculty of Medicine, Department of Ophthalmology, İzmir/TURKEY
3M.D. Associate Professor, Dokuz Eylül University Faculty of Medicine, Department of Ophthalmology, İzmir/TURKEY
4M.D. Professor, Dokuz Eylül University Faculty of Medicine, Department of Ophthalmology, İzmir/TURKEY Purpose: To retrospectively evaluate the clinical and imaging features of patients diagnosed and treated as Vogt-Koyanagi-Harada (VKH) syndrome.
Materials and Methods: Medical records of patients treated as VKH syndrome between 2008 and 2012 were evaluated retrospectively. Patients with a follow-up shorter than three months were excluded. Fundus fluoresein angiography (FA), optic coherence tomography (OCT) and if available magnetic resonance imaging features were evaluated. All patients were classified according to the revised diagnostic criteria for VKH Syndrome as “complete”, “incomplete” and “probable”.
Results: Twenty-four eyes of 12 patients (seven women and five men) were included. Mean follow-up was 19,2 months (SD: ±17, 4-48 months). The mean age at baseline was 39,6 years (SD:±17.0; 22-65 years). Six patients were classified as complete, five incomplete and one probable. All patients had bilateral involvement and exudative retinal detachment was present. Mean visual acuity at baseline was 4/10 (0,5/10- 10/10). Visual acuity was lower than 6/10 in 17 eyes (%71). All patients except of one were treated with pulse corticosteroids following by oral corticosteroid therapy. Remission was gained with oral corticosteroids in one patient. Additional immunmodulatory therapy was used in five patients. Intravitreal steroid and methotrexate was applied in one resistant case in addition to systemic therapy. Mean visual acuity after therapy increased from 0.4 (±0.39) to 0.84'e (±0.25).
Conclusion: VKH syndrome is a rare ocular inflammatory disease in which the etiology is not clear. Because of variable clinical features differential diagnosis can be difficult. Good visual results can be obtained by early recognition and an effective treatment. Keywords : Exudative detachment, fundus fluorescein angiography, uveitis, Vogt-Koyanagi-Harada syndrome