Iwahashi Chiharu, Okuno Kensuke, Hashida Noriyasu, Nakai Kei, Ohguro Nobuyuki, Nishida Kohji
Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan.
Jpn J Ophthalmol. 2015 May;59(3):157-63. doi: 10.1007/s10384-015-0377-1. Epub 2015 Mar 26.
Our aim was to determine the recurrence rate of inflammation in Vogt-Koyanagi-Harada (VKH) disease and to describe its clinical features.
We retrospectively evaluated patients diagnosed as having VKH disease with exudative retinal detachment at the Osaka University Hospital or the Japanese Community Healthcare Organization, Osaka Hospital, between 1998 and 2012. All patients received high-dose corticosteroid therapy as the initial treatment and were followed for at least 6 months. Demographic data, including age, sex, visual acuity (VA) levels at initial presentation and at 1 year after initial therapy, treatment received, and recurrent episodes were reviewed.
Fifty-five consecutive patients with VKH disease were identified (36 women; mean age 38.6 ± 10.4 years). Fourteen patients (25.5 %) had recurrent inflammation, which manifested as posterior uveitis in eight and as anterior uveitis in six of the patients. Recurrent posterior segment inflammation was more likely to develop in patients whose VA at initial presentation was poor (P = 0.039) and in whom orally administered corticosteroid was tapered rapidly (to 30 mg within 3 weeks or less, to 20 mg within 2 months or less, and to 10 mg within 3 months or less) (P = 0.006, P = 0.066, and P = 0.041, respectively).
About 25 % of patients with VKH disease had recurrent inflammation. Poor initial VA and rapid tapering of the corticosteroid were associated with posterior recurrence.
我们的目的是确定伏格特-小柳-原田（VKH）病炎症的复发率并描述其临床特征。
我们回顾性评估了1998年至2012年间在大阪大学医院或日本社区医疗保健组织大阪医院被诊断为患有伴有渗出性视网膜脱离的VKH病的患者。所有患者均接受大剂量皮质类固醇治疗作为初始治疗，并随访至少6个月。回顾了人口统计学数据，包括年龄、性别、初诊时和初始治疗后1年时的视力（VA）水平、接受的治疗以及复发情况。
共确定了55例连续的VKH病患者（36例女性；平均年龄38.6±10.4岁）。1十四名患者（25.5%）出现炎症复发，其中8例表现为后葡萄膜炎，6例表现为前葡萄膜炎。初诊时视力差的患者（P = 0.039）以及口服皮质类固醇迅速减量的患者（在3周内或更短时间减至30 mg，在2个月内或更短时间减至20 mg，在3个月内或更短时间减至10 mg）（分别为P = 0.006、P = 0.066和P = 0.041）更易发生后段炎症复发。
约25%的VKH病患者出现炎症复发。初诊时视力差和皮质类固醇迅速减量与后部复发有关。
