Frequency of distinguishing clinical features in Vogt-Koyanagi-Harada disease.
OBJECTIVE
To determine the frequency of occurrence of limited clinical features which distinguish patients with Vogt-Koyanagi-Harada (VKH) disease from those with non-VKH uveitis.


METHODS
Comparative case series.


METHODS
We included 1147 patients.


METHODS
All patients with bilateral ocular inflammatory disease presenting to any of 10 uveitis centers in the 3-month period between January 1 and March 31, 2006 (inclusive), were asked to participate. The clinical and historical features of disease were obtained from the participants via direct interview and chart review. Patients were stratified based on whether they were diagnosed with VKH disease or non-VKH uveitis for statistical analysis.


METHODS
Presence or absence of various clinical features in the 2 populations.


RESULTS
Of 1147 patients, 180 were diagnosed with VKH disease and 967 with non-VKH uveitis. Hispanics and Asians were more likely to be diagnosed with VKH than non-VKH disease compared with other ethnicities. In acute disease, the finding of exudative retinal detachment was most likely to be found in VKH disease with a positive predictive value (PPV) of 100 and negative predictive value (NPV) of 88.4, whereas in chronic disease, sunset glow fundus was most likely to be found, with a PPV of 94.5 and NPV of 89.2.


CONCLUSIONS
Numerous clinical findings have been described in the past as important in the diagnosis of VKH. The current study reveals that of these, 2 are highly specific to this entity in an ethnically and geographically diverse group of patients with nontraumatic bilateral uveitis. These clinical findings are exudative retinal detachment during acute disease and sunset glow fundus during the chronic phase of the disease.
Rao
Narsing A
NA
Doheny Eye Institute and Department of Ophthalmology, Keck School of Medicine of University of Southern California, Los Angeles, California 90033, USA. nrao@usc.edu
Gupta
Amod
A
Dustin
Laurie
L
Chee
Soon Phaik
SP
Okada
Annabelle A
AA
Khairallah
Moncef
M
Bodaghi
Bahram
B
Lehoang
Phuc
P
Accorinti
Massimo
M
Mochizuki
Manabu
M
Prabriputaloong
Tisha
T
Read
Russell W
RW
D000208:Acute Disease; D000328:Adult; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D014605:Uveitis / Q000175:diagnosis; D014607:Uveomeningoencephalitic Syndrome / Q000175:diagnosis*