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.
Similar content being viewed by others
References
Moorthy RS Inomata J, Rao NA. (1995) Vogt-Koyanagi-Harada syndrome. Surv Ophthalmol 39:265–292
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 131:647–652
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 140:509–516
Rubsamen PE, Gass JDM (1991) Vogt-Koyanagi-Harada syndrome: clinical course, therapy, and long-term visual outcome. Arch Ophthalmol 109:682–687
Sasamoto Y, Ohno S, Matsuda J (1990) Studies on corticosteroid therapy in Vogt-Koyanagi-Harada disease. Ophthalmologica 201:162–167
Sugiura S (1978) Vogt-Koyanagi-Harada disease. Jpn J Ophthalmol 22:9–35
Beniz J, Forster DJ, Lean JS, Smith RE, Rao NA (1991) Variations in clinical features of the Vogt-Koyanagi-Harada syndrome. Retinal 11:275–280
Ohno S, Char DH, Kimura SJ, O'Connor GR (1977) Vogt-Koyanagi-Harada syndrome. Am J Ophthalmol 83:735–740
Suzuki S (1999) Quantitative evaluation of 'sunset glow' fundus in Vogt-Koyanagi-Harada disease. Jpn J Ophthalmol 43:327–333
Bouchenaki N, Herbort CP (2001) The contribution of indocyanine green angiography to the appraisal and management of Vogt-Koyanagi-Harada disease. Ophthalmology 108:54–64
Acknowledgements
The authors wish to thank Dr. John Vincent Flores for his invaluable help with the statistical analysis.
Author information
Authors and Affiliations
Corresponding author
Additional information
The authors have no financial relationship with the Singapore Eye Research Institute that has sponsored this research, and they have full control of all primary data. They agree to allow International Ophthalmology to review the data if requested.
Rights and permissions
About this article
Cite this article
Chee, SP., Jap, A. & Bacsal, K. Spectrum of Vogt-Koyanagi-Harada disease in Singapore. Int Ophthalmol 27, 137–142 (2007). https://doi.org/10.1007/s10792-006-9009-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10792-006-9009-6