Band-shaped keratopathy in Chinese patients with Vogt-Koyanagi-Harada syndrome.

PURPOSE

To determine the incidence and characterize the clinical features of band-shaped keratopathy in Chinese patients with Vogt-Koyanagi-Harada (VKH) syndrome.

METHODS

The data of 360 consecutive VKH patients examined from November 2000 to December 2008 were reviewed. The patients were diagnosed with VKH syndrome according to international criteria. The data of VKH patients with band-shaped keratopathy, including age at disease onset, gender, intervals between disease onset and emergence of this complication, other complications, and therapy were collected and analyzed.

RESULTS

Of the 360 VKH patients, 66 patients (132 eyes) visited us at the stage of posterior uveitis or anterior uveal involvement. None of these 132 eyes had band-shaped keratopathy develop. The other 294 VKH patients (587 eyes) visited us at the stage of recurrent, granulomatous, anterior uveitis, and band-shaped keratopathy was observed in 21 eyes of 13 patients (3.6%). Of these 13 patients, there were 6 men and 7 women. Band-shaped keratopathy in 21 eyes was observed from 9 months to 32 years, with a mean of 12.7 years after the first uveitis attack. These patients had been intermittently treated with systemic corticosteroids and occasionally in combination with a transient use of either chlorambucil or azathioprine. All the eyes with band-shaped keratopathy showed recurrent and chronic intraocular inflammation. Complicated cataract, increased intraocular pressure and decreased intraocular pressure were observed in 18, 12, and 5 eyes, respectively. Ocular phthisis was observed in 1 eye. The best-corrected vision of 0.3 or less was observed in 85.1% of the affected eyes.

CONCLUSIONS

Band-shaped keratopathy is a relatively uncommon complication in VKH syndrome and mostly occurs in relatively younger patients with a long course of chronic intraocular inflammation. It was frequently associated with complicated cataract and secondary glaucoma and was a marker for poor visual outcome.