Chronic Recurrent Vogt-Koyanagi-Harada Disease and Development of 'Sunset Glow Fundus' Predict Worse Retinal Sensitivity

Ocul Immunol Inflamm. 2017 Aug;25(4):475-485. doi: 10.3109/09273948.2016.1139730. Epub 2016 Mar 22.

Abstract

Purpose: To investigate prognostic factors for retinal sensitivity assessed by microperimetry in patients with Vogt-Koyanagi-Harada (VKH) disease.

Methods: In total, 34 patients with initial-onset acute disease and 19 patients with chronic recurrent disease were retrospectively evaluated.

Results: The mean follow-up period was 40.4 ± 40.5 months. Sensitivity was significantly worse in eyes with more severe anterior segment inflammation at presentation, as indicated by the presence of mutton-fat keratic precipitates, anterior chamber reaction ≥2+, and posterior synechiae. Chronic recurrent presentation, development of complications, and 'sunset glow fundus' were significantly associated with worse sensitivity. Using logistic regression analysis, better sensitivity was significantly associated with initial-onset acute presentation (odds ratio, OR = 6.9; 95% confidence interval, CI = 1.53-9.66).

Conclusions: Chronic recurrent presentation and development of complications and 'sunset glow fundus' are associated with a worse sensitivity outcome.

Keywords: Immunomodulatory therapy; Vogt–Koyanagi–Harada disease; microperimetry; outcome; retinal sensitivity.

MeSH terms

  • Administration, Oral
  • Adolescent
  • Adult
  • Child
  • Chronic Disease
  • Female
  • Follow-Up Studies
  • Fundus Oculi
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / therapeutic use
  • Humans
  • Injections, Intravenous
  • Male
  • Methylprednisolone / administration & dosage
  • Methylprednisolone / therapeutic use
  • Middle Aged
  • Prognosis
  • Recurrence
  • Retina / physiopathology*
  • Retinal Diseases / diagnosis*
  • Retinal Diseases / drug therapy
  • Retinal Diseases / physiopathology
  • Retrospective Studies
  • Uveomeningoencephalitic Syndrome / diagnosis*
  • Uveomeningoencephalitic Syndrome / drug therapy
  • Uveomeningoencephalitic Syndrome / physiopathology
  • Visual Acuity / physiology*
  • Visual Field Tests
  • Visual Fields / physiology
  • Young Adult

Substances

  • Glucocorticoids
  • Methylprednisolone