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María Fernanda Golzarri, Rashel Cheja-Kalb, Luz Elena Concha del Rio, Maria de Lourdes Arellanes Garcia; Risk factors for subretinal fibrosis in patients with Vogt-Koyanagi-Harada syndrome.. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4201.
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To identify the risk factors for the development of subretinal fibrosis (SRF) among patients with Vogt-Koyanagi-Harada (VKH) syndrome.
In this case control study, demographic and clinical characteristics of VKH Mexican mestizo patients with and without subretinal fibrosis were compared. The study population was obtained from clinical records at a Uveitis clinic in Mexico City. Cases were defined as having subretinal fibrosis and VKH diagnosis, controls were patients with VKH syndrome without subretinal fibrosis.
Clinical data from 58 patients (116 eyes) with VKH who met the diagnostic criteria was collected. Twenty seven were included as cases, and 31 as controls. The median lapse between symptoms and clinical detection of subretinal fibrosis was 7 months (IQR 3.5 to 32.5), and the median lapse between VKH diagnosis at our clinic and subretinal fibrosis detection was 2 months (IQR 1 - 12 months). Location of clinically diagnosed SRF was macular 45.8%(n=11), peripapilar 37.5%(n=9) and elsewhere 16.7%(n=4).Univariate analysis revealed that risk factors for the development of subretinal fibrosis included: late medical attention (patients who were diagnosed later than 4 weeks (OR 4.469, 95% CI 1.227 - 16.275), bullous retinal detachment (OR 4.68, 95% CI 1.49 - 14.71). After adjustment for age, sex, BCVA during admission and duration of symptoms before treatment (more than 4 weeks), bullous serous retinal detachment (adjusted OR 11.97, 95% CI 1.84 - 77.97), and time from symptoms to treatment (more than 4 weeks delay in receiving treatment (adjusted OR 16.5, 05% CI 1.49-181.4)) were also statistically significant risk factors for this complication.
Patients with Vogt Koyanagi Harada syndrome with bullous retinal detachments, have an 11 times higher risk of developing long term retinal fibrosis . Delay in receiving treatment was also associtated with highty risk of developing subretinal fibrosis. To our knowledge, this is the first analytic study describing the risk factors for subretinal fibrosis in VHK.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Table 1. Basal characteristics of study population
Table 2. Logistic regression model
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