[Clinical manifestations and diagnosis of Vogt-Koyanagi-Harada syndrome].
OBJECTIVE
To investigate the clinical features, causes of blindness and diagnosis of Vogt-Koyanagi-Harada (VKH) syndrome.


METHODS
The data of 157 patients with VKH syndrome were reviewed and analyzed. Patients were carefully examined with slit lamp, ophthalmoscope, three-mirror lens, fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and HLA typing.


RESULTS
Headache was noted in 73.5% of these patients. Simultaneous involvement of both eyes occurred in 80.8% of these patients. Choroiditis, papilledema and edema of the retina adjacent to the optic nerve were noted in 100% of these patients in the posterior uveitis stage, whereas recurrent granulomatous anterior uveitis (98.4%), "sunset glow" fundus (95.8%) and Dalen-Fuchs nodules (71.2%) were the common ocular findings in the recurrent anterior uveitis stage. The common causes of blindness were papillitis, exudative retinal detachment and complicated cataract in the posterior uveitis stage, anterior uveal involvement stage and its recurrent stage. Poliosis (36.3%) and alopecia (35.0%) were the most common extraocular findings. Early irregular patches of fluorescence, followed by localized hyperfluorescent spots were the typical findings of FFA. Dilation of choroidal vessels and leakage of ICG from the choroidal vessels were the common ICGA findings. The prevalence of HLA-DR4 and HLA-DRw53 in patients (54.9% and 71.8% respectively) was significantly higher than that in controls (14.7% and 38.2% respectively).


CONCLUSIONS
VKH syndrome is characterized by choroiditis, papillitis or neuroretinitis in the posterior uveitis stage, followed by a generalized uveitis with a typical recurrent granulomatous anterior uveitis. Extraocular findings and relevant examinations including FFA, ICGA and HLA typing are helpful to the diagnosis of VKH syndrome.
Yang
Peizeng
P
Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China. ypzn@gzsums.edu.cn
Wang
Hong
H
Zhou
Hongyan
H
Huang
Xiangkun
X
Zhong
Huahong
H
Chen
Ling
L
Zhong
Hui
H
Fu
Tao
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D005451:Fluorescein Angiography; D006680:HLA Antigens; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014607:Uveomeningoencephalitic Syndrome / Q000175:diagnosis*
D006680:HLA Antigens