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R. W. Read; Vogt-Koyanagi-Harada Disease in African-Americans. Invest. Ophthalmol. Vis. Sci. 2008;49(13):811.
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To define the clinical presentation and outcomes in African-American patients with Vogt-Koyanagi-Harada disease (VKH).
Retrospective chart review of all patients with VKH seen on the uveitis service of the University of Alabama at Birmingham from 8/2000 to 11/2007. Charts were reviewed for demographic data and clinical findings, treatment, and outcome.
Thirteen patients with VKH were identified as having been seen during the study period. Seven (54%) were African-American. Two of the seven had been seen only once and were excluded. Of the remaining 5 with follow up visits, three (60%) had presented in the chronic phase of the disease and two (40%) in the acute phase. All five were female. Mean age at presentation was 39.6 years (range 18-52). At presentation vision was 20/50 or worse in 80% of eventually better seeing eyes, while vision was 20/200 or worse in 60%. Cataract, glaucoma, choroidal neovascular membrane, and subretinal fibrosis were respectively present in 60%, 20%, 0%, and 20% of better seeing eyes. During follow up, the rate of visual loss to 20/50 or worse in better seeing eyes was 0.05 per eye-year at risk and to 20/200 or worse was 0.02 per eye-year at risk. Rates of complication development in better seeing eyes per eye-year were: cataract 0.07, glaucoma 0.02, CNVM 0.0, and subretinal fibrosis 0.05. The median time from disease onset to uveitis center presentation for those with vision in the better seeing eye of 20/40 or better was 2 months, while for those 20/200 or worse it was 12 months.
While VKH remains an uncommon disease in African-Americans world-wide, local rates of involvement reflect local ethnic populations. Contrary to previous reports suggesting a worse outcome for African-Americans with VKH, the current study suggests no difference from data reported from mixed ethnic populations. A shorter time to presentation to a uveitis center may improve outcome.
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