Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, 734-8551, Japan.
Department of Ophthalmology, Hiroshima Prefectural Hospital, Hiroshima, Japan.
Int Ophthalmol. 2023 Aug;43(8):2857-2866. doi: 10.1007/s10792-023-02688-0. Epub 2023 Mar 17.
To investigate the incidence and pre/post-treatment risk factors of glaucoma in patients with Vogt-Koyanagi-Harada (VKH) disease.
Data regarding secondary glaucoma were collected from the medical records of patients with VKH disease who were followed up at the uveitis service at Hiroshima University for more than 6 months. We examined the incidence of glaucoma and pre/post-treatment risk factors for glaucoma in patients with VKH disease.
Forty-nine patients with VKH disease were included in this study (31 women and 18 men). The mean age at onset was 50.4 ± 15.4 years and the mean length of follow-up was 40.7 ± 25.5 months. The most common initial treatment was pulse intravenous corticosteroid therapy (89.8%). Fifteen patients developed secondary glaucoma during follow-up. The median time of glaucoma onset from VKH development was 4.5 months (range 0-44 months). Disc swelling type as a pre-treatment factor (p = 0.089, hazard ratio = 7.268), worse final best corrected visual acuity (p = 0.099, odds ratio = 1.545), and cataract progression (p = 0.076, odds ratio = 7.886) as post-treatment factors showed trends for glaucoma development. The patients who progressed to the chronic recurrent stage had more complications including glaucoma.
Secondary glaucoma occurred in more than 30% of patients with VKH disease. The factors that showed a trend toward glaucoma development may reflect an association with delayed treatment initiation and prolonged ocular inflammation.
调查 Vogt-小柳-原田（VKH）病患者中青光眼的发生率和治疗前后的危险因素。
从在广岛大学葡萄膜炎科接受随访超过 6 个月的 VKH 病患者的病历中收集有关继发性青光眼的数据。我们检查了 VKH 病患者中青光眼的发生率以及青光眼的治疗前后危险因素。
本研究纳入了 49 例 VKH 病患者（31 名女性和 18 名男性）。发病年龄的平均值为 50.4±15.4 岁，平均随访时间为 40.7±25.5 个月。最常见的初始治疗是脉冲静脉内皮质类固醇治疗（89.8%）。15 例患者在随访期间发生了继发性青光眼。从 VKH 发病到青光眼发病的中位时间为 4.5 个月（范围 0-44 个月）。治疗前的视盘肿胀类型（p=0.089，风险比=7.268）、最终最佳矫正视力较差（p=0.099，优势比=1.545）和白内障进展（p=0.076，优势比=7.886）作为治疗后的因素显示出青光眼发展的趋势。进展为慢性复发性阶段的患者有更多的并发症，包括青光眼。
超过 30%的 VKH 病患者发生了继发性青光眼。显示出青光眼发展趋势的因素可能反映了与延迟治疗开始和延长眼内炎症有关。
