Department of Ophthalmology, University of Alberta, Edmonton, Alta.
Can J Ophthalmol. 2013 Jun;48(3):146-52. doi: 10.1016/j.jcjo.2012.10.008.
The objective of this article was to describe the incidence, clinical characteristics, and visual outcomes of Vogt-Koyanagi-Harada disease in First Nations and Métis individuals.
A retrospective chart review.
Nineteen First Nation and Métis Canadian residents in Northern Alberta.
Electronic records for a 17-year period (1994-2010) were reviewed. Charts were reviewed for age, sex, length of follow-up, location of primary residence, diagnostic criteria at presentation, disease stage at presentation, duration of symptoms before presentation, ocular and extraocular manifestations at presentation, treatments, compliance, and complications. The time to an eye reaching 20/40, 20/200, and a halving of the baseline visual angle was plotted using Kaplan-Meier methodology.
Of 19 First Nations and Métis individuals identified, 84.2% were female, and the average age at presentation was 30.8 years. The most common presenting symptom and sign were blurred vision (89.5%) and anterior segment inflammation (89.5%), respectively. Fifteen (78.9%) patients had extraocular manifestations, the most common being alopecia (26.3%) and cerebrospinal fluid pleocytosis (26.3%). All patients were initially treated with corticosteroids; immunomodulatory therapy was used for 2 (10.5%) patients. Twelve (63.2%) patients experienced ocular complications; 47.4% of patients had difficulty with treatment compliance and attending follow-up appointments. The median time to achieve 20/40 vision was shorter for compliant patients compared with noncompliant patients (P = 0.048).
The features of Vogt-Koyanagi-Harada disease in First Nations and Métis Canadians are most similar to series of South Asian and Hispanic patients. Compliant patients were found to achieve 20/40 vision significantly sooner than noncompliant patients.
本文旨在描述在加拿大第一民族和梅蒂斯人群中 Vogt-Koyanagi-Harada 病的发病率、临床特征和视力预后。
回顾性图表审查。
艾伯塔省北部的 19 名第一民族和梅蒂斯加拿大居民。
对 17 年期间（1994-2010 年）的电子记录进行了回顾。对图表进行了年龄、性别、随访时间、主要居住地位置、初诊时的诊断标准、初诊时的疾病分期、初诊前症状持续时间、初诊时的眼部和眼部外表现、治疗、依从性和并发症等方面的评估。使用 Kaplan-Meier 方法绘制达到 20/40、20/200 和基线视角减半的时间图。
在所确定的 19 名第一民族和梅蒂斯个体中，84.2%为女性，平均发病年龄为 30.8 岁。最常见的首发症状和体征分别为视力模糊（89.5%）和前段炎症（89.5%）。15 名（78.9%）患者有眼部外表现，最常见的是脱发（26.3%）和脑脊液白细胞增多（26.3%）。所有患者最初均接受皮质类固醇治疗；2 名（10.5%）患者使用免疫调节治疗。12 名（63.2%）患者发生眼部并发症；47.4%的患者在治疗依从性和定期随访方面存在困难。与不依从患者相比，依从患者达到 20/40 视力的中位时间更短（P = 0.048）。
加拿大第一民族和梅蒂斯人群中 Vogt-Koyanagi-Harada 病的特征与南亚和西班牙裔患者的系列研究最相似。依从性较好的患者明显更快地达到 20/40 视力。
