Jap A, Luu C D, Yeo I, Chee S-P
Singapore National Eye Centre, Singapore, Singapore.
Eye (Lond). 2008 Feb;22(2):240-5. doi: 10.1038/sj.eye.6702591. Epub 2006 Sep 15.
To determine the correlation between systemic corticosteroid therapy and the occurrence and size of peripapillary atrophy (PPA) in patients with Vogt-Koyanagi-Harada (VKH) disease.
All patients with VKH disease were retrospectively reviewed for their corticosteroid regimen. The extent of the PPA, if present, was measured using digitized imaging software, by two masked observers. Eyes with myopia greater than 6 dioptres or glaucoma were excluded. The patients were classified into three groups: early high (EH), late high (LH), and low dose (LD), according to the dose and timing of corticosteroids received during the acute phase of the disease.
There were 40 eyes in the EH group, 25 eyes in the LH group, and 23 eyes in the LD group. Multivariate analysis showed that corticosteroid therapy was the main determinant of PPA occurrence. All the eyes in the LD group had PPA and eyes in the LH groups were 4.02 times (95% confidence interval 1.24-13.07) more likely to develop PPA than those in the EH group. The LD group also had larger PPA to disc ratios than the EH group. (Mean of 2.83 vs0.19, P<0.001).
The development and extent of PPA in patients with VKH disease appear to be dependent on the dose and timing of systemic corticosteroids.
确定伏格特-小柳-原田（VKH）病患者全身皮质类固醇治疗与视乳头周围萎缩（PPA）的发生及大小之间的相关性。
对所有VKH病患者的皮质类固醇治疗方案进行回顾性分析。若存在PPA，由两名不知情的观察者使用数字化成像软件测量其范围。排除近视度数大于6屈光度或患有青光眼的眼睛。根据疾病急性期接受皮质类固醇的剂量和时间，将患者分为三组：早期高剂量组（EH）、晚期高剂量组（LH）和低剂量组（LD）。
EH组有40只眼，LH组有25只眼，LD组有23只眼。多变量分析显示，皮质类固醇治疗是PPA发生的主要决定因素。LD组所有眼睛均有PPA，LH组眼睛发生PPA的可能性是EH组的4.02倍（95%置信区间1.24 - 13.07）。LD组的PPA与视盘比率也高于EH组。（平均值分别为2.83和0.19，P<0.001）。
VKH病患者PPA的发生和程度似乎取决于全身皮质类固醇的剂量和时间。
