International Ophthalmology

, Volume 27, Issue 2–3, pp 137–142 | Cite as

Spectrum of Vogt-Koyanagi-Harada disease in Singapore

Original Paper

Abstract

Purpose  Review of all cases of Vogt-Koyanagi-Harada disease (VKH) handled in the Uveitis Clinic of the Singapore National Eye Centre, with the aim of determining the clinical spectrum of this disease in these patients and the outcomes of treatment.

Methods  The case notes were retrospectively analyzed for patient demographics, clinical signs, investigations, complications and treatment received. The treatment groups were classified according to the steroid regimen (dose and timing). The early-high (EH) group received ≥1 mg/kg per day of systemic prednisolone within 2 weeks of presenting with symptoms, the late-high (LH) group received the same dose between 2 and 4 weeks of presenting with symptoms, and the low-dose (LD) group received no or lower doses of oral corticosteroids, or received the same high dose, but only after more than 1 month of presenting with symptoms.

Results  A total of 178 eyes of 89 patients, mainly of Chinese ethnicity, were examined. The mean age of the patients at onset of the study was 41.80 ± 14.65 (SE) years, and there were nearly equal numbers of male and female patients. The mean duration of the follow-up was 9.42 years (±9.87 years). There were 60 eyes in the EH group, 18 in the LH group, and 68 in the LD group. When the results on our patient group were compared to known data on a number of other ethnic groups, our patients were found to be similar to the Japanese with respect to gender distribution and prevalence, to the Hispanics for alopecia, and to the non-Hispanics of North America for tinnitus and vitiligo. The EH group were more likely to achieve complete resolution, with fewer complications, than the LD group, but one third of the former still developed chronic disease.

Conclusion  Higher doses of systemic steroids may be required to ensure adequate immunosuppression in VKH patients.

Keywords

Southeast Asia Vogt-Koyanagi-Harada disease 

References

  1. 1.
    Moorthy RS Inomata J, Rao NA. (1995) Vogt-Koyanagi-Harada syndrome. Surv Ophthalmol 39:265–292CrossRefGoogle Scholar
  2. 2.
    Read RW, Holland GN, Rao NA, Tabbara KF, Ohno S, Arellanes-Garcia L. et al. (2001) Revised diagnostic criteria for Vogt-Koyanagi-Harada disease: report of an International Committee on Nomenclature. Am J Ophthalmol 131:647–652PubMedCrossRefGoogle Scholar
  3. 3.
    Standardization of Uveitis Nomenclature (SUN) Working Group (2005) Standardization of uveitis nomenclature for reporting clinical data. Results of the first international workshop. Am J Ophthalmol 140:509–516Google Scholar
  4. 4.
    Rubsamen PE, Gass JDM (1991) Vogt-Koyanagi-Harada syndrome: clinical course, therapy, and long-term visual outcome. Arch Ophthalmol 109:682–687PubMedGoogle Scholar
  5. 5.
    Sasamoto Y, Ohno S, Matsuda J (1990) Studies on corticosteroid therapy in Vogt-Koyanagi-Harada disease. Ophthalmologica 201:162–167PubMedCrossRefGoogle Scholar
  6. 6.
    Sugiura S (1978) Vogt-Koyanagi-Harada disease. Jpn J Ophthalmol 22:9–35Google Scholar
  7. 7.
    Beniz J, Forster DJ, Lean JS, Smith RE, Rao NA (1991) Variations in clinical features of the Vogt-Koyanagi-Harada syndrome. Retinal 11:275–280CrossRefGoogle Scholar
  8. 8.
    Ohno S, Char DH, Kimura SJ, O'Connor GR (1977) Vogt-Koyanagi-Harada syndrome. Am J Ophthalmol 83:735–740PubMedGoogle Scholar
  9. 9.
    Suzuki S (1999) Quantitative evaluation of 'sunset glow' fundus in Vogt-Koyanagi-Harada disease. Jpn J Ophthalmol 43:327–333PubMedCrossRefGoogle Scholar
  10. 10.
    Bouchenaki N, Herbort CP (2001) The contribution of indocyanine green angiography to the appraisal and management of Vogt-Koyanagi-Harada disease. Ophthalmology 108:54–64PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Soon-Phaik Chee
    • 1
    • 3
    • 4
  • Aliza Jap
    • 1
    • 2
  • Kristine Bacsal
    • 1
  1. 1.Ocular Inflammation and ImmunologySingapore National Eye CentreSingaporeSingapore
  2. 2.Division of OphthalmologyChangi General HospitalSingaporeSingapore
  3. 3.Singapore Eye Research InstituteSingaporeSingapore
  4. 4.Department of OphthalmologyNational University of SingaporeSingaporeSingapore

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