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On-Tat Lee, Hassan A Aziz, Jeffery Tan, Jesse L Berry, Damien C Rodger, Narsing A Rao; Chronic manifestations of Vogt-Koyanagi-Harada disease. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4136. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To report the clinical findings in chronic Vogt-Koyanagi-Harada (VKH) disease patients.
The current study is a consecutive, comparative case series. The ocular history, medication history and clinical findings of 17 patients clinically diagnosed with chronic VKH at the Los Angeles County + USC Medical Center who were seen during a 2 month period were reviewed.
Of the 17 patients, 70.6% were female and 100% were Hispanic. The mean age during their last clinical exam was (40.5) years (range, 21-65). Among the 34 eyes, persistently active disease was seen in (35.3%) and quiescent disease was seen in (64.7%). 8.8% of the tested eyes had a visual acuity less or equal to 20/200. The majority of patients were on systemic immunosuppressant medications: 88.2% were on oral corticosteroids and 52.9% were on systemic corticosteroids plus one or more steroid sparing agents (azathioprine, cyclosporine, infliximab, methotrexate or mycophenolate). Ocular manifestations included: chronic anterior uveitis (14.7%), chronic posterior uveitis (14.7%), serous retinal detachment (5.9%), fundus depigmentation (64.7%), nummular scars (58.8%), and retinal pigment epithelium clumping (70.6%). Other findings (on presentation or previously surgical treated) included: cataracts (82.4%) glaucoma (35.3%), choroidal neovascular membranes in (11.8%), and subretinal fibrosis (20.6%).
In the current study, all VKH patients were of Hispanic ethnicity with a female predominance. Most patients were undergoing treatment with a combination of systemic corticosteroids with immunomodulatory/corticosteroid sparing agents. Despite chronic complications, most patients retained good visual acuity of 20/100 or better with combination of corticosteroids and steroid sparing agents.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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