Analysis Of The Clinical Treatment Of Vogt-Koyanagi-Harada Syndrome

Object:To investigate the clinical characteristic, diagnosis,treatment and treatment effect ofVogt-Koyana-Harada (VKH) syndrome.Methods: A retrospective study was conducted based on the clinical data of20patients (39eyes) with VKHsyndrome who were admitted to the First Affiliated Hospital of the Medical College of the ShiheziUniversity from January2001to December2011. The clinical data were analyzed, including ocularsymptoms, systemic symptoms, fundus fluorescein angiograghy(FFA), optical coherencetomography(OCT),ultrasound biomicroscope(UBM),treatment method and the result. A high-dosecorticosteroids were given to all patients to control the inflammatory response.Results: All of the20patients (39eyes) were initial patients, simultaneous involvement of both eyesoccurred in19cases, only one case had the unilateral disease. Of the20patients，two cases weremisdiagnosed as glaucoma, two cases as acute retinal pigment epithelitis, two cases as optic nerve retinitis,one case as central serous chorioretinopathy.Prior to the onset of the disease,14patients(70％) hadprodromal symptoms such as headache, nausea, vomiting. External ocular symptoms were noted in80％of the patients, including neurologic symptoms, auditory problems, poliosis, alopecia and vitiligo. Thespecific performances of FFA were irregular punctate hyperfluorescent dots, disc leakage and multiplehyperfluorescent pool in the subretina. All patients were treated with high-dose corticosteroids for9-12months. The vision of the patients improved differently. After6months’ following-up,3cases relapsed.Conclusion: Prodrome, clinical course, external ocular symptoms and FFA are helpful to the diagnosis ofVKH syndrome. Early and aggressive systemic treatment with corticosteroids has greatly improved thevisual outcome in VKH patients. But there is a tendency of recurrence, and long-term follow-up should beclosely observed.