The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Lab of Ophthalmology, Chongqing Eye Institute, Chongqing, China
The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Lab of Ophthalmology, Chongqing Eye Institute, Chongqing, China.
Br J Ophthalmol. 2021 Dec;105(12):1678-1682. doi: 10.1136/bjophthalmol-2020-316323. Epub 2020 Oct 3.
BACKGROUND/AIMS: This study was performed to examine the prevalence, risk factors and treatment outcome of OHT/glaucoma in Chinese patients with Vogt-Koyanagi-Harada (VKH).
Retrospective non-interventional case series were conducted on a total of 2281 patients with VKH referred from April 2008 to April 2019. Of these cases, 1457 had a minimum follow-up period of 3 months and were included for this study. Medical records were reviewed for demographic, ocular and treatment data.
Among 2914 eyes of 1457 patients with VKH, 695 (23.9%) eyes of 425 patients (29.2%) developed OHT/glaucoma. The risk factors of OHT/glaucoma included initial BCVA of 20/200 or worse (OR=4.826), final best-corrected visual acuity (BCVA) of 20/50-20/100 (OR=5.341) and final BCVA of 20/200 or worse (OR=4.235), the interval between uveitis attack and referral time interval being 2 months or more (OR=3.318), more than three recurrent episodes (OR=4.177) and posterior synechiae (OR=1.785). The main possible mechanisms of OHT/glaucoma were inflammatory factor-induced open-angle OHT/glaucoma in 277 eyes (39.9%) and pupillary block arising from complete posterior synechiae in 201 eyes (28.9%). In these 695 eyes with OHT/glaucoma, normalised intraocular pressure (IOP) was achieved in 389 eyes (56.0%) following medical treatment. In the remaining 306 eyes, various surgical interventions were performed and a normalised IOP could be achieved in 249 eyes (81.4%).
OHT/glaucoma is a common complication in Chinese patients with VKH. Risk factors of OHT/glaucoma included worse acuity at first and final visits, the longer interval between uveitis attack and referral, more recurrent episodes and posterior synechiae.
背景/目的：本研究旨在检查中国人 Vogt-Koyanagi-Harada（VKH）患者中 OHT/青光眼的患病率、危险因素和治疗结果。
对 2008 年 4 月至 2019 年 4 月间转诊的 2281 例 VKH 患者进行回顾性非干预性病例系列研究。其中 1457 例患者的随访时间至少为 3 个月，纳入本研究。回顾性分析了人口统计学、眼部和治疗数据。
在 2914 只 VKH 眼的 1457 例患者中，695 只（23.9%）眼的 425 例（29.2%）患者发生了 OHT/青光眼。OHT/青光眼的危险因素包括初始 BCVA 为 20/200 或更差（OR=4.826）、最终最佳矫正视力（BCVA）为 20/50-20/100（OR=5.341）和最终 BCVA 为 20/200 或更差（OR=4.235）、葡萄膜炎发作与转诊时间间隔为 2 个月或以上（OR=3.318）、反复发作次数超过 3 次（OR=4.177）和后粘连（OR=1.785）。OHT/青光眼的主要可能机制为炎症因子引起的开角型 OHT/青光眼 277 只眼（39.9%）和完全后粘连引起的瞳孔阻滞 201 只眼（28.9%）。在这 695 只患有 OHT/青光眼的眼中，389 只眼（56.0%）经药物治疗后眼压正常。在其余 306 只眼中，进行了各种手术干预，249 只眼（81.4%）眼压可恢复正常。
OHT/青光眼是中国人 VKH 患者的常见并发症。OHT/青光眼的危险因素包括初诊和最终就诊时视力较差、葡萄膜炎发作与转诊时间间隔较长、反复发作次数较多和后粘连。
