Vogt-Koyanagi-Harada syndrome. Epidemiological aspects and clinical coursein 20 cases.

Purpose We retrospectively compared outcome in 20 patients with Vogt-Koyanagi-harad a syndrome with results reported in the literature. Patients and methods The charts of 20 patients attending the ophthalmology A unit of a specializ ed hospital in Rabat over a 7-year period between 1990 and 1997 were retros pectively reviewed. Results There were 15 women (75%). Mean age was 30 years (18-40 years). The prodrom al stage was characterized by headache (100 %), meningism (25 %) and psychi atric changes (10 %). In 100 % of cases, both eyes were involved with visua l acuity less than 1/10 in 65 % and serious retinal detachment in 95 %, Int egumentary, signs occurred in 9 patients (45 %), with alopecia (40 %), poli osis (40 %) and vitiligo (20 %). Lumbar puncture showed cerebrospinal fluid pleocytosis in 16 patients (80 %) and audiometry, revealed sensor it neura l hearing loss in II cases (55 %). HLA typing, performed in only 5 patients , showed HLA DR4 in 100 %, All of our patients were treated with systemic s teroids and two of them had received immunosuppressives therapy. Long-term complications were cataract (25 %) and intra-ocular pressure elevation (30 %). After a mean follow-up of 6 years, 87,5 % of our patients have visual a cuity of 5/10 or better. Conclusion Vogt-Koyanagi-Harada syndrome is common in Morocco, and visual prognosis is fair in most of the cases. It appears that cases in Morocco are more simil ar to those in the Asiatic population than in the American population.