[Vogt-Koyanagi-Harada syndrome. Epidemiological, clinical and disease progression aspects. Twenty cases].
OBJECTIVE
We retrospectively compared outcome in 20 patients with Vogt-Koyanagi-harada syndrome with results reported in the literature.


METHODS
The charts of 20 patients attending the ophthalmology A unit of a specialized hospital in Rabat over a 7-year period between 1990 and 1997 were retrospectively reviewed.


RESULTS
There were 15 women (75%). Mean age was 30 years (18-40 years). The prodromal stage was characterized by headache (100%), meningism (25%) and psychiatric changes (10%). In 100% of cases, both eyes were involved with visual acuity less than 1/10 in 65% and serious retinal detachment in 95%. Integumentary signs occurred in 9 patients (45%), with alopecia (40%), poliosis (40%) and vitiligo (20%). Lumbar puncture showed cerebrospinal fluid pleocytosis in 16 patients (80%) and audiometry revealed sensory neural hearing loss in 11 cases (55%). HLA typing, performed in only 5 patients, showed HLA DR4 in 100%. All of our patients were treated with systemic steroids and two of them had received immunosuppressive therapy. Long-term complications were cataract (25%) and intra-ocular pressure elevation (30%). After a mean follow-up of 6 years, 87.5% of our patients have visual acuity of 5/10 or better.


CONCLUSIONS
Vogt-Koyanagi-Harada syndrome is common in Morocco, and visual prognosis is fair in most of the cases. It appears that cases in Morocco are more similar to those in the Asiatic population than in the American population.
Service d'Ophtalmologie A, Hôpital des Spécialités, Rabat, Maroc.
N
N
Boutimzine
A
A
Laghmari
I
I
Ouazzani
W
W
Ibrahimy
Z
Z
Mohcine
D000293:Adolescent; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D018450:Disease Progression; D005260:Female; D015804:HLA-DR4 Antigen / Q000235:genetics; D006782:Hospitals, Special; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D009018:Morocco; D012163:Retinal Detachment / Q000209:etiology; D012189:Retrospective Studies; D013256:Steroids; D016896:Treatment Outcome; D014607:Uveomeningoencephalitic Syndrome / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000235:genetics; D014792:Visual Acuity
D000893:Anti-Inflammatory Agents; D015804:HLA-DR4 Antigen; D007166:Immunosuppressive Agents; D013256:Steroids