Analysis of 87 cases with Vogt-Koyanagi-Harada Disease

Purpose: Vogt-Koyanagi-Harada (VKH) disease is known to have varied manifes tations in different ethnic groups. Tn order to analyze the clinical profil e of VKH cases in the Indian population, we studied 87 consecutive cases of VKH disease treated in an uveitis clinic in South India between 1985 and 1 996. Methods: Retrospective analysis and review of charts of consecutive new VKH cases diagnosed in a referral clinic. Results: VKH disease comprised 2.2% of all uveitis referrals. Extraocular s ymptoms or signs were seen in 64% of cases at the time of presentation. Mos t common was meningism (95.9%). However, subsequently all patients develope d extraocular manifestations. Panuveitis (92%) was the commonest presentati on. Systemic corticosteroid was the usual form of therapy (50.3%) followed by immunosuppressive therapy (39%); surgical treatment was needed in 8% of the cases. Complicated cataract (33%) and glaucoma (24%) were major complic ations. Final vision was between 6/60 and 6/18 in 88% of the cases and 6/18 and better in 15.4%; there was no improvement in 11% of the cases. Conclusions: VKH disease occurs less frequently in India than in Japan and about as commonly as in the United States. Extraocular signs are far less c ommon than in the Japanese population. Visual prognosis is good in patients presenting within 1 month of onset of symptoms. Immunosuppressive agents a nd vitreoretinal surgery are needed in advanced cases and in cases reported later. Jpn J Ophthalmol 2000; 44:296-301 (C) 2000 Japanese Ophthalmologica l Society.