The clinical features of acute Vogt–Koyanagi–Harada syndrome with optic disc edema and serous retinal detachment_Chinese Journal of Ocular Fundus Diseases

Authors：

Jiang Zhijian ¹ , Zhu Maoli ¹ , Zhang Nan ¹ , Zhang Hui ¹ , Zhou Min ² ,  Dong Jianhong ¹

1. Department of Ophthalmology, Shanghai Xuhui District Central Hospital, Shanghai 200031, China;
2. Department of Ophthalmology, The Eye-ENT Hospital of Fudan University, Shanghai 200031, China;

Corresponding author：

Dong Jianhong, Email: dongjianhong@hotmail.com

Keywords：

Uveomeningoencephalitic syndrome; Retinal detachment; Papilledema

DOI：

10.3760/cma.j.cn511434-20200112-00013

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Objective To compare the clinical features of patients with acute Vogt-Koyanagi-Harada syndrome (VKH syndrome) of optic disc swelling (ODS) and serous retinal detachment (RD).Methods A retrospective clinical study. From January 2013 to November 2019, 212 patients with acute VKH syndrome diagnosed in the Department of Ophthalmology of Shanghai Xuhui District Central Hospital were included in the study. Among them, there were 105 males (210 eyes) and 107 females (214 eyes). The average age was 40.84±13.90 years. All affected eyes were examined by BCVA, FFA, and OCT. The standard logarithmic visual acuity chart was used for BCVA examination, which was converted into logMAR visual acuity in statistics. According to the changes in the fundus, the patients were divided into the ODS group and the RD group, 36 patients with 72 eyes (16.98%) and 176 patients with 352 eyes (83.02%), respectively. The independent sample t test was performed to compare the age of onset, visit time and BCVA of the two groups of patients, the χ² test was performed to compare the count data.Results Among the 72 eyes of 36 patients in the ODS group, there were 16 males with 32 eyes (44.44%), 20 females with 40 eyes (55.56%). The average age was 40.56±16.57 years, the average visit time was 22.47±19.98 days, the average logMAR BCVA was 0.68±0.53. Among the 352 eyes of 176 patients in the RD group, there were 89 male patients with 178 eyes (50.56%), and 87 female patients with 174 eyes (49.43%). The average age was 40.90±13.34 years, the average visit time was 17.25±24.40 days, the average logMAR BCVA was 0.80±0.56. The average age (t=－0.116), gender composition ratio (χ²=0.448), average visit time (t=1.204), average logMAR BCVA (t=－1.661) comparisons between the two groups showed no statistically significant differences (P＞0.05). There was no statistically significant difference in the average logMAR BCVA between the RD group and the ODS group of different eyes (t=0.227, 0.810; P＞0.05). There were 50 (69.44%, 50/72) and 272 (77.27%, 272/352) eyes in the ODS group and RD group with inflammation of the anterior segment. There were anterior segment reactions between the two groups. There was no statistically significant difference in the number of eyes (χ²=1.003, P＞0.05). There were 34 (19.32%, 34/176) and 2 (5.56%, 2/36) patients with headache and hearing loss, respectively. The comparison of the number of patients with headache and hearing loss between the two groups showed statistically significant differences (χ²=4.015, P＜0.05).Conclusion Compared the patients with ODS acute VKH syndrome, the patients with serous RD acute VKH syndrome are more likely to have extraocular symptoms such as headache and hearing loss.

Citation： Jiang Zhijian, Zhu Maoli, Zhang Nan, Zhang Hui, Zhou Min, Dong Jianhong. The clinical features of acute Vogt–Koyanagi–Harada syndrome with optic disc edema and serous retinal detachment. Chinese Journal of Ocular Fundus Diseases, 2020, 36(11): 857-860. doi: 10.3760/cma.j.cn511434-20200112-00013 Copy

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1. Rao NA, Gupta A, Dustin L, et a1. Frequency of distinguishing clinical features in Vogt-Koyanagi-Harada disease[J]. Ophthalmology, 2010, 117(3): 591-599. DOI: 10.1016/j.ophtha.2009.08.030.
2. Yang P, Zhong Y, Du L, et al. Development and evaluation of diagnostic criteria for Vogt-Koyanagi-Harada disease[J]. JAMA Ophthalmol, 2018, 136(9): 1025-1031. DOI: 10.1001/jamaophthalmol.2018.2664.
3. Yang HK, Park KH, Kim JS, et al. Bilateral disc edema in a patient with Vogt-Koyanagi-Harada disease[J]. Can J Ophthalmol, 2014, 49(2): 54-56. DOI: 10.1016/j.jcjo.2014.01.002.
4. 杨培增. 葡萄膜炎诊断与治疗[M]. 北京: 人民卫生出版社, 2008: 754.Yang PZ. Diagnosis and treatment of uveitis[M]. Beijing: People's Medical Publishing House, 2008: 754.
5. Yang P, Ren Y, Li B, el a1. Clinical characteristics of Vogt-Koyanagi-Harada syndrome in Chinese patients[J]. Ophthalmology, 2007, 114(3): 606-614. DOI: 10.1016/j.ophtha.2006.07.040.
6. Chee SP, Jap A, Bacsal K. Spectrum of Vogt-Koyanagi-Hamda disease in Singapore[J]. Int Ophthalmol, 2007, 27(2-3): 137-142. DOI: 10.1007/s10792-006-9009-6.
7. Bordaberry MF. Vogt-Koyanagi-Harada disease: diagnosis and treatments update[J]. Curr Opin Ophthalmol, 2010, 21(6): 430-435. DOI: 10.1097/ICU.0b013e32833eb78c.
8. Fang W, Yang P. Vogt-Koyanagi-Harada syndrome[J]. Curr Eye Res, 2008, 33(7): 517-523. DOI: 10.1080/02713680802233968.
9. Okunuki Y, Tsubota K, Kezuka T, et al. Differences in the clinical features of two types of Vogt-Koyanagi-Harada disease: serous retinal detachment and optic disc swelling[J]. Jpn J Ophthalmol, 2015, 59(2): 103-108. DOI: 10.1007/s10384-014-0367-8.
10. 郑曰忠. Vogt-小柳-原田病的诊治进展及存在问题[J]. 中华眼科杂志, 2012, 48(6): 572-576. DOI: 10.3760/cma.j.issn.0412-4081.2012.06.021.Zheng YZ. Progresses and existed problems on the diagnosis and treatment of Vogt-Koyanagi-Harada disease[J]. Chin J Ophthalmol, 2012, 48(6): 572-576. DOI: 10.3760/cma.j.issn.0412-4081.2012.06.021.
11. 王文吉, 周旻. Vogt-小柳-原田综合征[J]. 中国眼耳鼻喉科杂志, 2013, 13(2): 88-90, 95. DOI: 10.3969/j.issn.1671-2420.2013.02.007.Wang WJ, Zhou M. Vogt-Koyanagi-Harada syndrome[J]. Chin J Ophthalmol and Otorhinolaryngol, 2013, 13(2): 88-90, 95. DOI: 10.3969/j.issn.1671-2420.2013.02.007.
12. Rao NA. Pathology of Vogt-Koyanagi Harada disease[J]. Int Ophthalmol, 2007, 27(2-3): 81-85. DOI: 10.1007/s10792-006-9029-2.
13. Nakao K, Abematsu N, Mizushima Y, et al. Optic disc swelling in Vogt-Koyanagi-Harada disease[J]. Invest Ophthalmol Vis Sci, 2012, 53(4): 1917-1922. DOI: 10.1167/iovs.11-8984.
14. Kiyomoto C, Imaizumi M, Kimoto K, et al. Vogt-Koyanagi-Harada disease in elderly Japanese patients[J]. Int Ophthalmol, 2007, 27(2-3): 149-153. DOI: 10.1007/s10792-007-9067-4.

Chinese Journal of Ocular Fundus Diseases

The clinical features of acute Vogt–Koyanagi–Harada syndrome with optic disc edema and serous retinal detachment

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