June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Clinical Outcomes of Vogt-Koyanagi-Harada Disease at a Tertiary Center in 194 Patients: The KKESH Uveitis Survey Study Group
Author Affiliations & Notes
  • Abdulaziz Alrushood
    Retina and Vitreous, KKESH, Riyadh, Saudi Arabia
    ophthalmology, Dammam universty, dammam, Saudi Arabia
  • J. Fernando Arevalo
    Retina and Vitreous, KKESH, Riyadh, Saudi Arabia
    Retina and Vitreous, Wilmer Eye Institute, Baltimore, MD
  • Hassan Al Dhibi
    Retina and Vitreous, KKESH, Riyadh, Saudi Arabia
  • Yahya Al-Zahrani
    Retina and Vitreous, KKESH, Riyadh, Saudi Arabia
  • Vishali Gupta
    Retina and Vitreous, KKESH, Riyadh, Saudi Arabia
  • sulaiman Alsulaiman
    Retina and Vitreous, KKESH, Riyadh, Saudi Arabia
  • Andres Lasave
    Retina and Vitreous, Clínica de Oftalmologia de Cali and Hospital Universitario del Valle, cali, Cambodia
  • Hanan Al-Shamsi
    Retina and Vitreous, KKESH, Riyadh, Saudi Arabia
  • Footnotes
    Commercial Relationships Abdulaziz Alrushood, None; J. Fernando Arevalo, None; Hassan Al Dhibi, None; Yahya Al-Zahrani, None; Vishali Gupta, Allergan (R); sulaiman Alsulaiman, None; Andres Lasave, None; Hanan Al-Shamsi, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 5381. doi:
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      Abdulaziz Alrushood, J. Fernando Arevalo, Hassan Al Dhibi, Yahya Al-Zahrani, Vishali Gupta, sulaiman Alsulaiman, Andres Lasave, Hanan Al-Shamsi, ; Clinical Outcomes of Vogt-Koyanagi-Harada Disease at a Tertiary Center in 194 Patients: The KKESH Uveitis Survey Study Group. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5381.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To describe ocular clinical characteristics, complications, surgical outcomes and treatment among patients with Vogt-Koyanagi-Harada (VKH) disease in a tertiary center over a 25-year period.

Methods: We retrospectively analyzed 194 patients (382) eyes diagnosed with VKH disease in a tertiary center from January 1986 through December 2011.

Results: VKH disease was diagnosed at a median age of 35.1 ± 12.8 years (range 7 to 68 years), occurred in 135 (69.6%) females, and was bilateral in 188 (96.9%) patients. Mean baseline best-corrected visual acuity (BCVA) was 20/125 (logMAR 0.8 ± 0.72) in both eyes. Symptoms duration was short (< 3 months) in 110 (56.7%) patients. A single episode occurred in 87 (44.8%) patients, and recurrent episodes in 107 (54%) patients. The most common form of presentation was panuveitis in 151 (77.8%) eyes. Retinal detachment (RD) was present in 164 (42.9%) eyes, an exudative retinal detachment (ERD) was diagnosed in 143 (87.2%) eyes, and tractional retinal detachment (TRD) in 21 (12.8%) cases. Oral prednisone was the first line of treatment in 168 (86.6%) patients. Immunosuppressive treatment with cyclosporine was employed in 87 (44.8%) patients, azathioprine in 58 (29.9%), intravenous steroid in 50 (25.8%), mycophenolate mofetil in 18 (9.3%), and methotrexate in 12 (6.2%) patients. During the 25 years of this study, 89 (45.9%) patients (136 eyes) underwent surgery. Visual acuity was better than 20/50 in 240 (62.8%) affected eyes and 20/200 or worse in 72 (18.8 %) affected eyes at the last visit. More common complications at the last visit were glaucoma in 135 (35.3%) eyes, followed by posterior synechia 96 (25.1%), cataract in 25 (6.5%), and choroidal neovascularization (CNV) in 21 (5.5%) eyes.

Conclusions: In Saudi Arabia, VKH uveitis affects predominantly young women. Bilateral panuveitis is the most common ocular manifestation. At presentation, retinal detachment is present in 164 (42.9%) eyes. Oral prednisone is the first line of treatment in these patients. More than 60% of eyes maintain a visual acuity of 20/50 or better.

Keywords: 746 uveitis-clinical/animal model  
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