Vogt-Koyanagi-Harada disease: clinical outcomes.
OBJECTIVE
To evaluate the effect of treatment on the incidence of vision impairment and structural ocular complications among patients with Vogt-Koyanagi-Harada (VKH) disease.


METHODS
Retrospective cohort study.


METHODS
setting: Single-center academic practice. study population: Twenty-four consecutive patients with VKH disease who were referred for evaluation and treatment from November 1984 through May 2004. procedures: Information on patients with VKH disease was entered retrospectively into a database and analyzed with time-dependent techniques. main outcome measures: Incidence of visual impairment and of structural ocular complications.


RESULTS
In better-seeing eyes, the frequencies of vision loss to 20/50 or worse and to 20/200 or worse at presentation were 50% and 30%, respectively. The incidence rates on follow-up examination for vision loss to 20/50 or worse and to 20/200 or worse were 9% per person-year and 7% per person-year in the better-seeing eye. Oral corticosteroid therapy was associated with a reduced risk of loss of visual acuity to the 20/200 or worse in the better-seeing eye (relative risk [RR] = 0.33; P = .05). The use of immunosuppressive drug therapy was associated with a reduced risk of vision loss to the 20/50 or worse and to the 20/200 or worse thresholds in the better-seeing eye (RR = 0.33; P = .05; and RR = 0.08; P = .04, respectively).


CONCLUSIONS
VKH disease may result in substantial visual impairment. The use of oral corticosteroid or immunosuppressive drug therapy may reduce the risk of vision loss during the follow-up period.
Bykhovskaya
Irina
I
Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Thorne
Jennifer E
JE
Kempen
John H
JH
Dunn
James P
JP
Jabs
Douglas A
DA
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014607:Uveomeningoencephalitic Syndrome / Q000150:complications* / Q000188:drug therapy*; D014786:Vision Disorders / Q000209:etiology / Q000517:prevention & control*; D014792:Visual Acuity
D005938:Glucocorticoids; D007166:Immunosuppressive Agents