Skip to main content
SpringerLink
Log in

Differences in the clinical features of two types of Vogt-Koyanagi-Harada disease: serous retinal detachment and optic disc swelling

  • Clinical Investigation
  • Published:
Japanese Journal of Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To elucidate the clinical differences between serous retinal detachment (RD)-type and optic disc (OD) swelling-type Vogt-Koyanagi-Harada (VKH) disease.

Methods

We performed a retrospective review of 96 patients with new-onset, active VKH disease. Patients were classified into serous RD-type or OD swelling-type VKH disease groups by means of optical coherence tomography and fluorescein angiography, and the differences between the 2 groups were analyzed.

Results

Eighty-two patients were classified as having RD-type VKH disease (34 men and 48 women, aged 40.5 ± 12.6 years) and 14 patients as having OD swelling-type VKH disease (1 man and 13 women, aged 54.6 ± 11.6 years). Patients with the OD swelling type had older onset (P < 0.001) and were more proportionately female (P = 0.02) than those with the RD type. OD swelling-type VKH disease had a longer interval between disease onset and treatment initiation (22.4 ± 14.0 days vs 12.6 ± 14.7 days; P = 0.02) and a higher frequency of chronic disease (64.3 vs 30.5 %; P = 0.03) than did serous RD-type VKH disease. In the OD swelling type, patients with pretreatment visual acuity (VA) lower than 20/20 developed chronic disease more frequently than did those with VA of 20/20 or better (P = 0.02).

Conclusions

Patients with OD swelling-type VKH disease are more likely to be female, have older onset, and develop chronic disease than patients with RD-type VKH disease. In OD swelling-type VKH disease, worse VA before treatment is associated with the development of chronic disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Rao NA, Gupta A, Dustin L, Chee SP, Okada AA, Khairallah M, et al. Frequency of distinguishing clinical features in Vogt-Koyanagi-Harada disease. Ophthalmology. 2010;117(591–9):e591.

    Article  Google Scholar 

  2. Mimura Y. Survey of etiology and diagnosis of Harada’s disease [in Japanese]. Folia Japonica de Ophthalmologica Clinica. 1984;35:2676–83.

    Google Scholar 

  3. Mimura Y, Yuasa T, Bando K, Matsumoto K, Moriyama H. Immunopathological and clinical studies on ocular allergic diseases [in Japanese]. Nihon Ganka Gakkai Zasshi. 1979;83:1909–75.

    CAS  PubMed  Google Scholar 

  4. Nakao K, Abematsu N, Mizushima Y, Sakamoto T. Optic disc swelling in Vogt-Koyanagi-Harada disease. Invest Ophthalmol Vis Sci. 2012;53:1917–22.

    Article  PubMed  Google Scholar 

  5. Kiyomoto C, Imaizumi M, Kimoto K, Abe H, Nakano S, Nakatsuka K. Vogt-Koyanagi-Harada disease in elderly Japanese patients. Int Ophthalmol. 2007;27:149–53.

    Article  PubMed  Google Scholar 

  6. Read RW, Holland GN, Rao NA, Tabbara KF, Ohno S, Arellanes-Garcia L, et al. Revised diagnostic criteria for Vogt-Koyanagi-Harada disease: report of an international committee on nomenclature. Am J Ophthalmol. 2001;131:647–52.

    Article  CAS  PubMed  Google Scholar 

  7. Herbort CP, Mantovani A, Bouchenaki N. Indocyanine green angiography in Vogt-Koyanagi-Harada disease: angiographic signs and utility in patient follow-up. Int Ophthalmol. 2007;27:173–82.

    Article  PubMed  Google Scholar 

  8. Chee SP, Jap A, Bacsal K. Prognostic factors of Vogt-Koyanagi-Harada disease in Singapore. Am J Ophthalmol. 2009;147(154–61):e1.

    PubMed  Google Scholar 

  9. Shima C, Haruta H, Saishin Y, Ohguro N, Tano Y. Significance of corticosteroid pulse-dose therapy in patients with Vogt-Koyanagi-Harada disease [in Japanese]. J Eye. 2008;25:851–4.

    Google Scholar 

  10. Chee SP, Jap A, Bacsal K. Spectrum of Vogt-Koyanagi-Harada disease in Singapore. Int Ophthalmol. 2007;27:137–42.

    Article  PubMed  Google Scholar 

  11. Read RW, Rechodouni A, Butani N, Johnston R, LaBree LD, Smith RE, et al. Complications and prognostic factors in Vogt-Koyanagi-Harada disease. Am J Ophthalmol. 2001;131:599–606.

    Article  CAS  PubMed  Google Scholar 

  12. Rubsamen PE, Gass JD. Vogt-Koyanagi-Harada syndrome: clinical course, therapy, and long-term visual outcome. Arch Ophthalmol. 1991;109:682–7.

    Article  CAS  PubMed  Google Scholar 

  13. Hirose S, Saito W, Yoshida K, Saito M, Dong Z, Namba K, et al. Elevated choroidal blood flow velocity during systemic corticosteroid therapy in Vogt-Koyanagi-Harada disease. Acta Ophthalmol. 2008;86:902–7.

    Article  PubMed  Google Scholar 

  14. Moorthy RS, Inomata H, Rao NA. Vogt-Koyanagi-Harada syndrome. Surv Ophthalmol. 1995;39:265–92.

    Article  CAS  PubMed  Google Scholar 

  15. Miyanaga M, Kawaguchi T, Miyata K, Horie S, Mochizuki M, Herbort CP. Indocyanine green angiography findings in initial acute pretreatment Vogt-Koyanagi-Harada disease in Japanese patients. Jpn J Ophthalmol. 2010;54:377–82.

    Article  PubMed  Google Scholar 

  16. Grunwald JE, Hariprasad SM, DuPont J. Effect of aging on foveolar choroidal circulation. Acta Ophthalmol. 1998;116:150–4.

    CAS  Google Scholar 

  17. Ito YN, Mori K, Young-Duvall J, Yoneya S. Aging changes of the choroidal dye filling pattern in indocyanine green angiography of normal subjects. Retina. 2001;21:237–42.

    Article  CAS  PubMed  Google Scholar 

  18. Aota T, Ebisawa N, Maruyama K, Yoneya S. Clinical and indocyanine green angiographic features in aged patients of Vogt-Koyanagi-Harada disease [in Japanese]. Jpn J Clin Ophthalmol. 2003;57:979–83.

    Google Scholar 

  19. Rajendram R, Evans M, Khurana RN, Tsai JH, Rao NA. Vogt-Koyanagi-Harada disease presenting as optic neuritis. Int Ophthalmol. 2007;27:217–20.

    Article  PubMed  Google Scholar 

  20. Hirata N, Hayashi T, Yamane S, Mizuki N, Takeuchi S. A case of Vogt-Koyanagi-Harada disease with papillitis [in Japanese]. J Eye. 2011;28:293–6.

    Google Scholar 

Download references

Acknowledgments

We thank Chisa Matsumoto, MD, MSc, PhD, Department of Internal Medicine, Tokyo Medical University, for advice on the statistical analysis.

Conflicts of interest

Y. Okunuki, None; K. Tsubota, None; T. Kezuka, None; H. Goto, None.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan

    Yoko Okunuki, Kinya Tsubota, Takeshi Kezuka & Hiroshi Goto

Authors
  1. Yoko Okunuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kinya Tsubota
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Takeshi Kezuka
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hiroshi Goto
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yoko Okunuki.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

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. Jpn J Ophthalmol 59, 103–108 (2015). https://doi.org/10.1007/s10384-014-0367-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10384-014-0367-8

Keywords

Search

Navigation