Sachdev Nishant, Gupta Vishali, Gupta Amod, Singh Ramandeep
Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India.
Int Ophthalmol. 2008 Oct;28(5):339-45. doi: 10.1007/s10792-007-9144-8. Epub 2007 Sep 26.
To describe the clinical profile, management, and outcome in seven patients with posterior segment recurrence in Vogt-Koyanagi-Harada (VKH) disease.
Retrospective chart review of all the patients of VKH disease presenting to our institute between 2001 and 2005 was carried out. Patients with a documented posterior segment recurrence during follow-up were included in this study. Their history, systemic associations, ocular findings, investigations, management strategies, and treatment response were noted.
Out of 82 VKH patients screened, documented posterior segment recurrence was seen in seven patients who included five women and two men, with a mean age of 33.7 years (range 22-55 years). At onset, two patients had incomplete and five had probable VKH disease. At the time of recurrence, four patients were on maintenance dose (5-10 mg/day) of oral corticosteroid while the remaining three were off treatment. The mean interval between the primary episode and posterior segment recurrence was 33.7 weeks (range 16-52 weeks). All posterior segment recurrences were bilateral and were characterized by vitritis (eight eyes), papillitis (14 eyes), multiple yellow-white oval subretinal lesions (six eyes), and exudative retinal detachment (10 eyes). The recurrences were managed with oral corticosteroids (1.0-1.5 mg/day) and Azathioprine (2.0-2.5 mg/day). Subsequently, three patients experienced a second episode of posterior segment recurrence, which also responded to the corticosteroid-Azathioprine combination.
Recurrences in VKH disease may involve predominantly the posterior segment, and respond well to the standard treatment.
描述7例Vogt-小柳-原田（VKH）病后段复发患者的临床特征、治疗及预后。
对2001年至2005年间在我院就诊的所有VKH病患者进行回顾性病历审查。纳入随访期间有后段复发记录的患者。记录他们的病史、全身关联情况、眼部检查结果、检查、治疗策略及治疗反应。
在筛查的82例VKH患者中，7例有后段复发记录，其中5例女性，2例男性，平均年龄33.7岁（范围22 - 55岁）。发病时，2例患者为不完全型，5例可能为VKH病。复发时，4例患者正在口服糖皮质激素维持剂量（5 - 10毫克/天），其余3例已停止治疗。初次发作与后段复发的平均间隔时间为33.7周（范围16 - 52周）。所有后段复发均为双侧，表现为玻璃体炎（8只眼）、视乳头炎（14只眼）、多个黄白色椭圆形视网膜下病变（6只眼）和渗出性视网膜脱离（10只眼）。复发采用口服糖皮质激素（1.0 - 1.5毫克/天）和硫唑嘌呤（2.0 - 2.5毫克/天）治疗。随后，3例患者经历了第二次后段复发，对糖皮质激素 - 硫唑嘌呤联合治疗也有反应。
VKH病的复发可能主要累及后段，对标准治疗反应良好。
