Department of Ophthalmology, University of Texas Health Science Center, 5282 Medical Drive #610, San Antonio, TX, 78229, USA.
Athena Eye Institute, San Antonio, TX, USA.
Int Ophthalmol. 2021 Mar;41(3):915-922. doi: 10.1007/s10792-020-01647-3. Epub 2021 Jan 5.
To describe the presentation, features, and outcomes of patients with Vogt-Koyanagi-Harada disease (VKH) seen by uveitis specialists in Oklahoma.
Clinical data were collected for 26 patients (52 eyes) diagnosed with VKH and seen between 1992 and 2018. Main outcome measures included rates of visual loss, ocular complications, and remission.
There were 11 Native American (NA) patients (11/26, 42.3%) and 15 non-Natives (n-NA). NA VKH patients were significantly more likely to present at a younger age (18.6 years) than n-NA VKH patients (30.1 years) (p = 0.023). NA patients were less likely to have meningismus (0.00 vs. 42.9%; 0.048) or systemic symptoms (50.0% vs. 93.3%; p = 0.023) than n-NA patients, but more likely to develop cataracts (100.0% vs. 66.7%; p = 0.003). There were similar rates of macular edema, epiretinal membrane, subretinal fibrosis, and recurrent uveitis between the two groups. Oral corticosteroid use was similar between both groups (72.7% vs. 86.7%; p = 0.61).
VKH may manifest with earlier disease course in NA patients than n-NA patients, particularly regarding ocular findings. However, NA patients were less likely to have systemic symptoms than n-NA patients.
描述俄克拉荷马州葡萄膜炎专家诊治的 Vogt-小柳原田病(VKH)患者的临床表现、特征和结局。
收集了 1992 年至 2018 年间诊断为 VKH 并接受治疗的 26 名患者(52 只眼)的临床资料。主要观察指标包括视力丧失、眼部并发症和缓解率。
共有 11 名(11/26,42.3%)为美国原住民(NA)患者和 15 名非原住民(n-NA)患者。与 n-NA VKH 患者(30.1 岁)相比,NA VKH 患者发病年龄更小(18.6 岁),差异具有统计学意义(p=0.023)。与 n-NA 患者相比,NA 患者发生脑膜炎(0.00 比 42.9%;0.048)或全身症状(50.0% 比 93.3%;p=0.023)的可能性更小,但发生白内障(100.0% 比 66.7%;p=0.003)的可能性更大。两组患者的黄斑水肿、视网膜前膜、视网膜下纤维化和葡萄膜炎复发率相似。两组患者的口服皮质类固醇使用率相似(72.7% 比 86.7%;p=0.61)。
与 n-NA 患者相比,NA 患者 VKH 疾病的发病更早,特别是眼部表现。然而,与 n-NA 患者相比,NA 患者发生全身症状的可能性更小。