Therapy And Prognostic Factors Of Visual Acuity In Patients With Vogt-Koyanagi-Harada Syndrome In The Early Stage

To analyze therapy and identify prognostic factors for final visual acuity(VA) in patients with VKH syndrome in the early stage.Patients diagnosed with VKH syndrome in one month after onset of disease between October 2006 and January 2008 were reviewed.The data recorded included age,sex,initial and final VA,interval between the onset of disease and starting treatment,the process of visual acuity variations from commencing treatment to achieving best VA,clinical ocular findings and extraocular manifestations at presentation,treatment received,complication, recurrence,and follow-up duration.Sixty eyes of thirty patients were identified.There were 13(43.3 %) male and 17(56.7%) female patients with a mean age of 35.57 years (range17-66 years).The mean duration of disease at presentation was 15.75±7.39 days.Of the 60 eyes,42(70.0%) eyes did finally achieve VA of>20/20, 54 eyes(90.0%) with a VA of>20/40,one eye was detected to have a final VA of<20/200.Ten eyes developed at least one complication,including cataract in four eyes,glaucoma in five eyes and combined glaucoma and cataract in one eye.The following factors were significantly associated with final VA of>20/20 by Cox regression model;better initial VA(p=0.015), absence of retinal detachment(p=0.000),sunset glow fundus(p=0.000) and complications(p=0.007 ). Intensive and prolonged systemic treatment with corticosteroids is recommended for the initial patients with VKH symdrome in the early stage.Initial VA,retinal detachment,sunset glow fundus and complication were found out to be the most independent influential factors for final VA of>20/20 in patients with VKH syndrome in the early stage.