Differences in the clinical features of two types of Vogt-Koyanagi-Harada disease: serous retinal detachment and optic disc swelling.

PURPOSE

To elucidate the clinical differences between serous retinal detachment (RD)-type and optic disc (OD) swelling-type Vogt-Koyanagi-Harada (VKH) disease.

METHODS

We performed a retrospective review of 96 patients with new-onset, active VKH disease. Patients were classified into serous RD-type or OD swelling-type VKH disease groups by means of optical coherence tomography and fluorescein angiography, and the differences between the 2 groups were analyzed.

RESULTS

Eighty-two patients were classified as having RD-type VKH disease (34 men and 48 women, aged 40.5 ± 12.6 years) and 14 patients as having OD swelling-type VKH disease (1 man and 13 women, aged 54.6 ± 11.6 years). Patients with the OD swelling type had older onset (P < 0.001) and were more proportionately female (P = 0.02) than those with the RD type. OD swelling-type VKH disease had a longer interval between disease onset and treatment initiation (22.4 ± 14.0 days vs 12.6 ± 14.7 days; P = 0.02) and a higher frequency of chronic disease (64.3 vs 30.5 %; P = 0.03) than did serous RD-type VKH disease. In the OD swelling type, patients with pretreatment visual acuity (VA) lower than 20/20 developed chronic disease more frequently than did those with VA of 20/20 or better (P = 0.02).

CONCLUSIONS

Patients with OD swelling-type VKH disease are more likely to be female, have older onset, and develop chronic disease than patients with RD-type VKH disease. In OD swelling-type VKH disease, worse VA before treatment is associated with the development of chronic disease.