Cherukuri Navya, Murthy Somasheila I, Tyagi Mudit
Smt. Kannuri Santhamma Center for Vitreoretinal Diseases, Kallam Anji Reddy Campus Anant Bajaj Retina Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India.
Uveitis and Ocular Immunology Services, Hyderabad, Telangana, India.
Indian J Ophthalmol. 2025 Jan 1;73(Suppl 1):S158-S163. doi: 10.4103/IJO.IJO_1251_24. Epub 2024 Oct 25.
To describe the clinical course and treatment outcomes of Vogt-Koyanagi-Harada (VKH) disease during pregnancy.
This retrospective study compares the clinical course and outcomes in pregnant and nonpregnant women with VKH. All VKH patients who were pregnant at presentation or on follow up and age-matched nonpregnant female controls during the study period (2013-2022) were included. Their best-corrected visual acuity (BCVA), clinical presentations, and treatment outcomes were analyzed.
Among the 532 female VKH patients, nine (1.7%) were included. Thirty nonpregnant patients were included as control. At presentation, the mean age in the study group was 26 years ± 6.48 standard deviation (SD) compared to the control group (mean 25.1 years ± 3.04). The mean BCVA was comparable between the two groups at presentation (study group 1.35 logarithm of the minimum angle of resolution [logMAR] vs. control group 0.76 logMAR; P = 0.05) and the final follow-up (study group 0.65 logMAR vs. control group 0.35 logMAR; P = 0.15). Participants with anterior segment inflammation (study group 77.7% vs. control group 70%; P = 0.65), the disease stage (early-stage VKH: study group 88.8% vs. control group 73.3%; P = 0.33), and disease exacerbation (study group 33.3% vs. control group 26.6%; P = 0.69) were all comparable between the study and control groups. Following treatment, 66.6% and 46.6% of the study and control groups, respectively, had sunset glow fundus ( P = 0.29). At the last follow-up, 44.4% and 26.6% of the study and control groups, respectively, had subretinal fibrosis ( P = 0.31).
Though pregnancy is an immunomodulatory state, the clinical course of VKH in pregnant patients can be similar to that of nonpregnant women and needs close monitoring and follow-up.
描述妊娠期间Vogt-小柳-原田（VKH）病的临床病程及治疗结果。
本回顾性研究比较了妊娠和非妊娠VKH女性患者的临床病程及结果。纳入了研究期间（2013 - 2022年）就诊时或随访期间怀孕的所有VKH患者以及年龄匹配的非妊娠女性对照。分析了她们的最佳矫正视力（BCVA）、临床表现和治疗结果。
在532例女性VKH患者中，纳入了9例（1.7%）。纳入30例非妊娠患者作为对照。就诊时，研究组的平均年龄为26岁±6.48标准差（SD），对照组为（平均25.1岁±3.04）。两组就诊时的平均BCVA相当（研究组最小分辨角对数[logMAR]为1.35，对照组为0.76 logMAR；P = 0.05），末次随访时也相当（研究组为0.65 logMAR，对照组为0.35 logMAR；P = 0.15）。研究组和对照组在前节炎症（研究组77.7%，对照组70%；P = 0.65）、疾病分期（早期VKH：研究组88.8%，对照组73.3%；P = 0.33）和疾病加重情况（研究组33.3%，对照组26.6%；P = 0.69）方面均相当。治疗后，研究组和对照组分别有66.6%和46.6%出现晚霞状眼底（P = 0.29）。在末次随访时，研究组和对照组分别有44.4%和26.6%出现视网膜下纤维化（P = 0.31）。
虽然妊娠是一种免疫调节状态，但妊娠患者VKH的临床病程可能与非妊娠女性相似，需要密切监测和随访。
