Doheny Eye Institute and Department of Ophthalmology, Keck School of Medicine of University of Southern California, Los Angeles, California 90033, USA.
Ophthalmology. 2010 Mar;117(3):591-9, 599.e1. doi: 10.1016/j.ophtha.2009.08.030. Epub 2009 Dec 24.
To determine the frequency of occurrence of limited clinical features which distinguish patients with Vogt-Koyanagi-Harada (VKH) disease from those with non-VKH uveitis.
Comparative case series.
We included 1147 patients.
All patients with bilateral ocular inflammatory disease presenting to any of 10 uveitis centers in the 3-month period between January 1 and March 31, 2006 (inclusive), were asked to participate. The clinical and historical features of disease were obtained from the participants via direct interview and chart review. Patients were stratified based on whether they were diagnosed with VKH disease or non-VKH uveitis for statistical analysis.
Presence or absence of various clinical features in the 2 populations.
Of 1147 patients, 180 were diagnosed with VKH disease and 967 with non-VKH uveitis. Hispanics and Asians were more likely to be diagnosed with VKH than non-VKH disease compared with other ethnicities. In acute disease, the finding of exudative retinal detachment was most likely to be found in VKH disease with a positive predictive value (PPV) of 100 and negative predictive value (NPV) of 88.4, whereas in chronic disease, sunset glow fundus was most likely to be found, with a PPV of 94.5 and NPV of 89.2.
Numerous clinical findings have been described in the past as important in the diagnosis of VKH. The current study reveals that of these, 2 are highly specific to this entity in an ethnically and geographically diverse group of patients with nontraumatic bilateral uveitis. These clinical findings are exudative retinal detachment during acute disease and sunset glow fundus during the chronic phase of the disease.
确定能够将 Vogt-Koyanagi-Harada（VKH）病患者与非 VKH 葡萄膜炎患者区分开来的有限临床特征的发生频率。
比较病例系列。
我们纳入了 1147 名患者。
在 2006 年 1 月 1 日至 3 月 31 日（包括在内）的 3 个月期间，我们邀请了 10 个葡萄膜炎中心的所有双侧眼部炎症性疾病患者参与。通过直接访谈和病历回顾从参与者那里获得疾病的临床和病史特征。根据患者是否被诊断为 VKH 病或非 VKH 葡萄膜炎进行分层，以进行统计分析。
在这 2 个群体中各种临床特征的存在或缺失。
在 1147 名患者中，有 180 名被诊断为 VKH 病，967 名被诊断为非 VKH 葡萄膜炎。与其他种族相比，西班牙裔和亚洲裔更有可能被诊断为 VKH 病，而非非 VKH 葡萄膜炎。在急性疾病中，渗出性视网膜脱离的发现最有可能与 VKH 病相关，其阳性预测值（PPV）为 100，阴性预测值（NPV）为 88.4；而在慢性疾病中，晚霞样眼底最有可能被发现，其 PPV 为 94.5，NPV 为 89.2。
过去有许多临床发现被描述为 VKH 诊断的重要依据。本研究表明，在一组来自不同种族和地理位置的、非外伤性双侧葡萄膜炎患者中，其中 2 种临床发现对 VKH 病具有高度特异性。这些临床发现是急性疾病期间的渗出性视网膜脱离和慢性疾病期间的晚霞样眼底。
