Mekkawy Mahmood O, Fouad Yousef Ahmed, Nowara Mohamed, Aziz Ihab Abdel
Al Mashreq Eye Center, Cairo, Egypt.
Department of Ophthalmology, Ain Shams University Hospitals, Giza, Egypt.
Oman J Ophthalmol. 2023 Feb 21;16(1):88-93. doi: 10.4103/ojo.ojo_376_21. eCollection 2023 Jan-Apr.
Vogt-Koyanagi-Harada (VKH) disease is a vision-threatening inflammatory disorder that is challenging in diagnosis and management.
Retrospective, record-based analysis of 54 eyes belonging to 27 adult patients that fulfilled the revised diagnostic criteria for VKH between January 2018 and January 2021. Demographic, clinical, and imaging data on presentation and during follow-up visits were collected for each patient. Available imaging studies included B-scan ultrasonography (B-scan US), spectral domain optical coherence tomography (OCT), fundus fluorescein angiography (FFA), and OCT angiography (OCT-A).
The female-to-male ratio was 2.38:1. Nineteen patients (70.37%) presented during an initial attack, while eight patients (29.63%) presented during recurrence. The most commonly presenting sign in the posterior segment was exudative retinal detachment (44 eyes, 81.48%). B-scan US was utilized in 4 eyes (7.41%), OCT was utilized in 48 eyes (88.89%) with the most common finding being subretinal fluid (43 eyes, 89.58%), FFA was performed in 39 eyes (72.22%) with the most common finding being punctate hyperfluorescence and late dye pooling (33 eyes, 84.62%), and OCT-A was performed in 30 eyes (55.56%), in which choriocapillaris flow deficit that correlated with disease activity was detectable in 25 eyes (83.33%). Improved visual acuity was noted in 85% of the eyes that were followed up.
Early diagnosis and treatment of VKH result in favorable visual outcome. Multimodal imaging, with the recent addition of OCT-A, provides complementary data that could serve in diagnosis and monitoring.
伏格特-小柳-原田（VKH）病是一种威胁视力的炎症性疾病，在诊断和治疗方面具有挑战性。
对2018年1月至2021年1月期间符合VKH修订诊断标准的27例成年患者的54只眼睛进行基于记录的回顾性分析。收集每位患者就诊时及随访期间的人口统计学、临床和影像学数据。可用的影像学检查包括B超扫描（B-scan US）、光谱域光学相干断层扫描（OCT）、眼底荧光血管造影（FFA）和光学相干断层扫描血管造影（OCT-A）。
男女比例为2.38:1。19例患者（70.37%）在初次发作时就诊，8例患者（29.63%）在复发时就诊。后段最常见的体征是渗出性视网膜脱离（44只眼，81.48%）。4只眼（7.41%）使用了B超扫描，48只眼（88.89%）使用了OCT，最常见的发现是视网膜下液（43只眼，89.58%）；39只眼（72.22%）进行了FFA，最常见的发现是点状高荧光和晚期染料渗漏（33只眼，84.62%）；30只眼（55.56%）进行了OCT-A，其中25只眼（83.33%）可检测到与疾病活动相关的脉络膜毛细血管血流缺损。在接受随访的眼睛中，85%的视力得到改善。
VKH的早期诊断和治疗可带来良好的视力预后。多模态成像，最近增加了OCT-A，提供了可用于诊断和监测的补充数据。
