Development and Evaluation of Diagnostic Criteria for Vogt-Koyanagi-Harada Disease

Abstract

IMPORTANCETo our knowledge, a set of well-defined diagnostic criteria is not yet developed for the diagnosis of Vogt-Koyanagi-Harada (VKH) disease.OBJECTIVE To develop and evaluate a set of diagnostic criteria for VKH disease using data from Chinese patients. DESIGN, SETTING, AND PARTICIPANTS This case-control study reviewed medical records of patients from a tertiary referral center between October 2011 and October 2016. Data from 634 patients with VKH disease and 623 patients with non-VKH uveitis from southern China were used to develop the Diagnostic Criteria for VKH Disease (DCV). Data from an additional group of 537 patients with a definite VKH disease diagnosis and 525 patients with non-VKH uveitis from northern China were used to evaluate the diagnostic criteria. MAIN OUTCOMES AND MEASURES Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and receiver operating characteristic. RESULTSOf the 1257 patients used to construct the DCV, 665 (52.9%) were male, and the mean (SD) age at disease onset was 38.6 (13.6) years. The 3-class model and 21 clinical findings were selected by latent class analysis. Variables with a high positive rate in the early-phase or late-phase VKH group or high specificity constituted essential parameters. Constellations of these essential parameters constructed the DCV. The sensitivity and NPV of the DCV were higher than those of the Revised Diagnostic Criteria for VKH Disease (RDC)

Initial-onset acute and chronic recurrent stages are two distinctive courses of Vogt-Koyanagi-Harada disease

“…In the diagnostic criteria consensus, a list of signs was described as characteristic features of early or late phases of the condition. However, this classification did not consider time from the onset of symptoms, and specific findings observed at certain time point from the symptoms presentation and outcomes related to the stage of VKH disease were not introduced [ 13 , 16 ]. Moreover, as an attempt to introduce a categorization of VKH patients in clinical studies, different intervals of time have been used [ 5 , 14 , 17 – 20 ].…”

“…In this regard, patients with an early course of the condition at diagnosis have been classified as having an early [ 15 ], a new onset-acute [ 19 ], an acute-resolved [ 31 ], an acute VKH disease [ 18 ] or an initial-onset acute VKH disease [ 8 , 17 ]. On the other hand, subjects with late presentation have been referred to as subacute [ 2 , 34 ], chronic [ 17 , 26 , 35 ] or late [ 7 , 15 , 16 ].…”

Biológiai terápia szisztémás alkalmazása a szemészetben

“…rológiai vagy bőrpanaszok társulnak. Feltételezett VKHbetegség esetén uveitis extraocularis manifesztáció nélkül alakul ki [5,6]. A VKH-szindróma adekvát terápiáját az akut fázisban alkalmazott kortikoszteroidok jelentik, melyet a későbbi stádiumokban immunmoduláns kezelés válthat fel [6].…”

Comparison of Clinical Features and Visual Outcome between Sympathetic Ophthalmia and Vogt–Koyanagi–Harada Disease in Chinese Patients

“…VogteKoyanagieHarada disease was diagnosed based on the criteria reported recently. 3 Data included age, gender, disease duration, ocular and systemic manifestations, ocular complications, best-corrected visual acuity (BCVA), and treatment at presentation and further follow-up visits. 4 History of ocular trauma or intraocular surgery and the interval between the insult and uveitis developing were also collected in SO patients.…”