Clinical Features of Cases of Vogt-Koyanagi-Harada Syndrome

Abstract

ÖzetAmaç: Vogt-Koyanagi-Harada (VKH) hastal›¤›na sahip olgular›m›z›n klinik özelliklerini sunmak. Gereç ve Yöntem:Ocak 2001-Ocak 2010 tarihleri aras›nda klini¤imize baflvuran toplam 10 VKH olgusuna ait t›bbi kay›tlar geriye dönük olarak incelendi. Sonuçlar:On erkek hastan›n ortalama yafl› 21.9 y›l idi. Ortalama takip süresi 16,2 ayd›. Yedi olguda iki tarafl› tutulum, üç olguda tek tarafl› tutulum mevcuttu. Toplam 17 gözün bafllang›ç görme keskinli¤i de¤erleri ortalama olarak 0,51 idi. Ondört gözde ön üveit, 12 gözde vitritis mevcuttu. Optik disk hiperemisi 16 gözde bulunmaktayd›. Oniki gözün eksüdatif retina dekolman› ve befl gözün hafif retinal depigmentasyon alanlar› mevcuttu. Tüm olgular fundus floresein anjiografisi ve ultrasonografi ile de¤erlendirilmiflti. ‹flitsel flikâyetler iki olguda görüldü. ‹lk muayene sürecinde alt› olgunun beyin omurilik s›v›s›nda pleositoz tespit edildi. Dört olguda cilt bulgular› görüldü. Tüm olgular yüksek doz oral kortikosteroid tedavisi ile tedavi edildi. Üç olguda ilave olarak siklosporin tedavisi eklendi. Sonuç görme düzeyi ortalama olarak 0,86 idi. Tart›flma: VKH hastal›¤›nda, özellikle erken dönemde baflvuran vakalarda görme prognozu genellikle iyi olmaktad›r. Görme düzeyini artt›rmada kortikosteroidlerle yap›lan tedavi oldukça etkili olup, kortikosteroid tedavisine dirençli olgularda immünsüpresif ilaçlar gerekli olabilir. (TJO 2010; 40: 250-4) Anahtar Kelimeler: Tedavi sonucu, uveit, Vogt-Koyanagi-Harada hastal›¤› Summary Purpose: To report the clinical features of our cases of Vogt-Koyanagi-Harada (VKH) disease. Material and Method: Medical records of totally 10 VKH patients whoResults: The mean age of 10 male patients was 21.9 years. The mean follow-up period was 16.2 months. Seven cases had bilateral involvement and three had unilateral. The mean initial visual acuity was 0.51 in a total of 17 eyes. Fourteen eyes had anterior uveitis and twelve eyes had vitritis. Optic disc hyperemia was present in sixteen eyes. Twelve eyes had exudative retinal detachment and five eyes had areas of slight retinal depigmentation. All cases were evaluated with fundus fluorescein angiography and ultrasonography. Auditory disturbances were seen in two cases. On first examination, pleocytosis was detected in the cerebrospinal fluid samples from six patients. Integumentary findings were seen in four cases. All subjects were treated with high-dose oral corticosteriod, but three of them additionally received cyclosporine therapy. The mean final visual acuity was 0.86. Discussion:In VKH disease, visual prognosis is generally good, especially in cases presenting in the early period. Treatment with corticosteroids is quite effective in improving the visual acuity, and immunosuppressive drugs may be needed in cases of corticosteroid resistance. (TJO 2010; 40: 250-4)