Boutimzine N, Laghmari A, Ouazzani I, Ibrahimy W, Mohcine Z
Service d'Ophtalmologie A, Hôpital des Spécialités, Rabat, Maroc.
J Fr Ophtalmol. 1998 Dec;21(10):746-54.
We retrospectively compared outcome in 20 patients with Vogt-Koyanagi-harada syndrome with results reported in the literature.
The charts of 20 patients attending the ophthalmology A unit of a specialized hospital in Rabat over a 7-year period between 1990 and 1997 were retrospectively reviewed.
There were 15 women (75%). Mean age was 30 years (18-40 years). The prodromal stage was characterized by headache (100%), meningism (25%) and psychiatric changes (10%). In 100% of cases, both eyes were involved with visual acuity less than 1/10 in 65% and serious retinal detachment in 95%. Integumentary signs occurred in 9 patients (45%), with alopecia (40%), poliosis (40%) and vitiligo (20%). Lumbar puncture showed cerebrospinal fluid pleocytosis in 16 patients (80%) and audiometry revealed sensory neural hearing loss in 11 cases (55%). HLA typing, performed in only 5 patients, showed HLA DR4 in 100%. All of our patients were treated with systemic steroids and two of them had received immunosuppressive therapy. Long-term complications were cataract (25%) and intra-ocular pressure elevation (30%). After a mean follow-up of 6 years, 87.5% of our patients have visual acuity of 5/10 or better.
Vogt-Koyanagi-Harada syndrome is common in Morocco, and visual prognosis is fair in most of the cases. It appears that cases in Morocco are more similar to those in the Asiatic population than in the American population.
我们回顾性地比较了20例Vogt-小柳-原田综合征患者的治疗结果与文献报道的结果。
回顾性分析了1990年至1997年期间在拉巴特一家专科医院眼科A科室就诊的20例患者的病历。
女性15例（75%）。平均年龄30岁（18 - 40岁）。前驱期的特征为头痛（100%）、脑膜刺激征（25%）和精神改变（10%）。100%的病例双眼受累，65%的患者视力低于1/10，95%的患者发生严重视网膜脱离。9例（45%）出现皮肤体征，包括脱发（40%）、白发（40%）和白癜风（20%）。16例（80%）腰椎穿刺显示脑脊液细胞增多，11例（55%）听力测定显示感音神经性听力损失。仅对5例患者进行了HLA分型，100%显示为HLA DR4。所有患者均接受了全身类固醇治疗，其中2例接受了免疫抑制治疗。长期并发症为白内障（25%）和眼压升高（30%）。平均随访6年后，87.5%的患者视力达到或优于5/10。
Vogt-小柳-原田综合征在摩洛哥很常见，大多数病例的视力预后良好。摩洛哥的病例似乎与亚洲人群的病例比与美国人群的病例更为相似。
