Limon S, Girard P, Bloch-Michel E, Guillevin L, Forest A
J Fr Ophtalmol. 1985;8(1):29-35.
We have studied 9 cases of the Vogt Koyanagi Harada (VKH) syndrome as defined by the criteria of the American Uveitis Society; all these cases presented evidence of past or present exudative retinal detachment (RD). In 2 cases the RD was shallow and limited to the posterior pole, in 3 cases encephalo-meningeal symptoms were absent, in 2 cases skin and hair symptoms were absent. In all, 5 cases in this series presented as an incomplete, dissociated form of the disease. However the clinical cause of the disease in these "formes frustes" was not simpler or quieter than in the complete forms; incomplete response or drug dependence were encountered with steroid therapy, and immunosuppressive drugs were used in 3 cases. It is to be noted that in one case an extensive RD involving the posterior pole occurred bilaterally: this RD did not respond to maximal steroid and immunosuppressive therapy and reattachment was obtained only after vitrectomy. In another case bilateral optic disc neovascularization was observed in association with severe papillitis despite heavy steroid therapy. A cure was obtained with immunosuppressive drugs.
我们依据美国葡萄膜炎协会的标准，对9例伏格特-小柳-原田（VKH）综合征患者进行了研究；所有这些病例均有过去或现在发生渗出性视网膜脱离（RD）的证据。其中2例RD较浅，局限于后极部；3例无脑膜脑炎症状；2例无皮肤和毛发症状。在这个系列中，共有5例表现为疾病的不完全、分离形式。然而，这些“顿挫型”疾病的临床病因并不比完全型简单或轻微；在类固醇治疗中遇到了反应不完全或药物依赖的情况，3例使用了免疫抑制药物。需要注意的是，有1例双侧后极部发生广泛的RD：这种RD对最大剂量的类固醇和免疫抑制治疗均无反应，仅在玻璃体切除术后才实现视网膜复位。在另一例中，尽管进行了大量类固醇治疗，但仍观察到双侧视盘新生血管形成并伴有严重视乳头炎。使用免疫抑制药物后病情得到治愈。
