Incidence and clinical features of recurrent Vogt-Koyanagi-Harada disease in Japanese individuals

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• 作者：Chiharu Iwahashi ; Kensuke Okuno ; Noriyasu Hashida…
• 关键词：Vogt ; Koyanagi ; Harada disease ; Uveitis ; Corticosteroid ; Tapering ; Recurrence
• 刊名：Japanese Journal of Ophthalmology
• 出版年：2015
• 出版时间：May 2015
• 年：2015
• 卷：59
• 期：3
• 页码：157-163
• 全文大小：489 KB
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• 作者单位：Chiharu Iwahashi (1)
  Kensuke Okuno (2)
  Noriyasu Hashida (1)
  Kei Nakai (3)
  Nobuyuki Ohguro (2)
  Kohji Nishida (1)
  
  1. Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan
  2. Department of Ophthalmology, Japanese Community Healthcare Organization Osaka Hospital, 4-2-78 Fukushima, Fukushima-ku, Osaka, 553-0003, Japan
  3. Department of Ophthalmology, Yodogawa Christian Hospital, Osaka, Japan
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Ophthalmology
  
• 出版者：Springer Japan
• ISSN：1613-2246

文摘

Purpose Our aim was to determine the recurrence rate of inflammation in Vogt-Koyanagi-Harada (VKH) disease and to describe its clinical features. Methods We retrospectively evaluated patients diagnosed as having VKH disease with exudative retinal detachment at the Osaka University Hospital or the Japanese Community Healthcare Organization, Osaka Hospital, between 1998 and 2012. All patients received high-dose corticosteroid therapy as the initial treatment and were followed for at least 6?months. Demographic data, including age, sex, visual acuity (VA) levels at initial presentation and at 1?year after initial therapy, treatment received, and recurrent episodes were reviewed. Results Fifty-five consecutive patients with VKH disease were identified (36 women; mean age 38.6?±?10.4?years). Fourteen patients (25.5?%) had recurrent inflammation, which manifested as posterior uveitis in eight and as anterior uveitis in six of the patients. Recurrent posterior segment inflammation was more likely to develop in patients whose VA at initial presentation was poor (P?=?0.039) and in whom orally administered corticosteroid was tapered rapidly (to 30?mg within 3 weeks or less, to 20?mg within 2 months or less, and to 10?mg within 3 months or less) (P?=?0.006, P?=?0.066, and P?=?0.041, respectively). Conclusions About 25?% of patients with VKH disease had recurrent inflammation. Poor initial VA and rapid tapering of the corticosteroid were associated with posterior recurrence.