Giordano Verónica E, Schlaen Ariel, Guzmán-Sánchez Martín J, Couto Cristobal
Department of Ophthalmology, Inflammatory Eye Diseases Service, Hospital de Clínicas Jose de San Martin, Buenos Aires C1120AAR, Argentina.
Department of Ophthalmology, Oculoplastic Service, Association for the Prevention of Blindness in Mexico, Vicente García Torres 46, San Lucas 04030, Coyoacán, Mexico City, Mexico.
Int J Ophthalmol. 2017 Jan 18;10(1):98-102. doi: 10.18240/ijo.2017.01.16. eCollection 2017.
To review all cases of Vogt-Koyanagi-Harada (VKH) disease in an Inflammatory Eye Disease Service in Argentina and to describe the clinical profile and outcomes of treatment.
The records from patients with VKH disease between January 1980 and December 2008 were retrospectively analyzed for clinical profile, complications, and treatment. Patients were classified according to their initial treatment in group 1: high corticosteroid dose [≥1 mg/(kg·d)] within 2wk of illness onset; group 2: high corticosteroid dose, 2 to 4wk of onset and group 3: patients who received the high dose after 1mo of illness onset, patients who received lower oral doses than 1 mg/(kg·d) without regarding the time of beginning of the disease.
A total of 210 eyes of 105 patients were included. The mean age at presentation was 32.6±13y (range: 10-74y), and 86.7% were female. The mean duration of follow up was 144±96.6mo. Patients in the group 1 had significantly higher visual acuity than the other groups (<0.0001), none had (loss of, or no) light perception at the end of follow up, whereas 24.7% patients in group 3 ended in light perception (<0.004).
Patients with early high dose corticosteroid treatment have better visual acuity and fewer complications. Proper timing in referral and treatment is critical for better visual outcome in VKH disease.
回顾阿根廷一家炎症性眼病诊疗机构中所有小柳原田（VKH）病病例，并描述其临床特征及治疗结果。
对1980年1月至2008年12月期间VKH病患者的病历进行回顾性分析，以了解其临床特征、并发症及治疗情况。根据患者初始治疗情况将其分为三组：第1组为发病2周内使用高剂量皮质类固醇[≥1mg/（kg·d）]；第2组为发病2至4周使用高剂量皮质类固醇；第3组为发病1个月后使用高剂量皮质类固醇，以及发病时间不限但口服剂量低于1mg/（kg·d）的患者。
共纳入105例患者的210只眼。就诊时的平均年龄为32.6±13岁（范围：10 - 74岁），女性占86.7%。平均随访时间为144±96.6个月。第1组患者的视力显著高于其他组（<0.0001），随访结束时均无光感丧失或无光感，而第3组有24.7%的患者最终无光感（<0.004）。
早期接受高剂量皮质类固醇治疗的患者视力更好，并发症更少。对于VKH病，正确的转诊和治疗时机对获得更好的视力结果至关重要。
