Clinical characteristics of Vogt-Koyanagi-Harada syndrome in Chinese patients
Clinical characteristics of Vogt-Koyanagi-Harada syndrome in Chinese patients
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DOI：
10.1016/j.ophtha.2006.07.040
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发表时间：
2007-03-01
期刊：
影响因子：
13.7
通讯作者：
Kijlstra, Aize
中科院分区：
文献类型：
--
作者：
Yang, Peizeng;Ren, Yalin;Kijlstra, Aize
目的：目的：探讨Vogt-小柳-原田综合征（VKH）的临床特点，方法：回顾性分析1995年8月至2005年4月间410例VKH患者的临床资料。在葡萄膜炎发作后2周内咨询我们的患者被分为第1组; 2周至2个月之间的患者被分为第2组; 2个月后的患者被分为第3组。所有患者的病史和临床表现进行了审查。在某些病例中进行了激光闪光细胞光度法、荧光素眼底血管造影、吲哚菁绿色血管造影、光学相干断层扫描、B超和超声生物显微镜检查。糖皮质激素主要用于治疗第1组和第2组患者，而环孢素或苯丁酸氮芥联合糖皮质激素用于第3组患者。主要结果测量：所有3组患者的人口统计学资料、临床表现和辅助检查。患者被诊断为完全（n = 273），不完全（n = 76），或可能（n = 61）VKH综合征。渗出性视网膜脱离和脉络膜炎或脉络膜视网膜炎是第1组的主要发现。在第2组中观察到后葡萄膜炎伴轻度至中度前葡萄膜炎，模拟非肉芽肿性炎症，如粉尘角膜沉淀物、前房细胞和闪光所证明。在第3组中观察到复发性肉芽肿性前葡萄膜炎伴“晚霞”眼底。并发性白内障是第3组患者最常见的并发症。在最后一次访视时，所有患者的葡萄膜炎均得到完全控制，第1、2和3组中< 20/200的最佳矫正视力分别为1.9%/眼年、1.2%/眼年和6%/眼年。Vogt-Koyanagi-Harada综合征在中国患者中以早期后葡萄膜炎为特征，如果综合征得不到控制，随后复发性肉芽肿性前葡萄膜炎。如果患者根据定制的免疫抑制治疗方案进行管理，则良好的视力预后是可能的。
Purpose: To characterize the clinical features of Vogt-Koyanagi-Harada syndrome (VKH) in Chinese patients.Design: Retrospective noncomparative case series.Participants: A total of 410 consecutive VKH patients examined from August 1995 to April 2005.Methods: Charts of these patients were reviewed according to international VKH criteria. Patients who consulted us within 2 weeks after a uveitis attack were classified into group 1; between 2 weeks and 2 months into group 2; and after 2 months into group 3. The history and clinical findings of all of the patients were reviewed. Laser flare-cell photometry, fundus fluorescein angiography, indocyanine green angiography, optical coherence tomography, B-scan ultrasonography, and ultrasound biomicroscopy were performed in certain cases. Corticosteroids were mainly used to treat patients in groups 1 and 2, whereas cyclosporine or chlorambucil in combination with corticosteroids were prescribed for patients in group 3.Main Outcome Measures: Demographics, clinical presentation, and ancillary examinations of the patients in all 3 groups.Results: The patients were diagnosed as having either complete (n = 273), incomplete (n = 76), or probable (n = 61) VKH syndrome. Exudative retinal detachment and either choroiditis or chorioretinitis were the main findings in group 1. Posterior uveitis with mild to moderate anterior uveitis simulating a nongranulomatous inflammation as evidenced by dust keratic precipitates, anterior chamber cells, and flare was noted in group 2. Recurrent granulomatous anterior uveitis with a "sunset glow" fundus was observed in group 3. Complicated cataract was the most common complication in the patients in group 3. At the final visit, the uveitis was completely controlled in all patients and a best-corrected visual acuity of < 20/200 was 1.9%/eye-year, 1.2%/eye-year, and 6%/eye-year in groups 1, 2, and 3, respectively.Conclusion: Vogt-Koyanagi-Harada syndrome in Chinese patients is characterized by early posterior uveitis, and if the syndrome is not controlled, subsequent recurrent granulomatous anterior uveitis. Good visual prognosis is possible if the patients are managed according to a tailored immunosuppressive treatment protocol.