Complications and prognostic factors in Vogt-Koyanagi-Harada disease

PURPOSE: To identify associations between complications of disease and fina l visual acuity in patients with Vogt-Koyanagi-Harada disease and to identi fy prognostic factors for disease outcome. METHODS: All patients diagnosed with Vogt-Koyanagi-Harada disease at the Do heny Eye Institute or the Los Angeles County/University of Southern Califor nia Medical Center between 1983 and 1997 were reviewed. Data extracted incl uded initial and final visual acuities, age, gender, ethnicity, complicatio ns, treatment, duration of disease, and number of recurrences. RESULTS: One hundred one patients with Vogt-Koyanagi-Harada disease were id entified, 68 (67%) of which were female. Mean age was 34 +/- 14 years (rang e, 8 to 75 years). Asians presented at a significantly older age than all o ther groups. One hundred three eyes (51%) developed at least one complicati on, including cataract in 84 eyes (42%), glau- coma in 54 eyes (27%), choro idal neovascular mem branes in 22 eyes (11%), and subretinal fibrosis in 13 eyes (6%), Patients who developed at least one compli cation had a signifi cantly longer median duration of disease and number of recurrent episodes o f inflammation (P =.0001 for each) than did those patients who developed no complications, Statistically significant asso ciations existed between poo r final visual acuity and greater numbers of complications (P =.001), great er age at onset (P =.03), a longer median duration of disease (P =.03), and greater number of recurrent episodes of inflammation (P =.0004). Eyes poss essing a better visual acuity at presentation were more likely to have a be tter visual acuity at final follow-up (P =.001). CONCLUSIONS: Factors associated with a worse final acuity included increasi ng numbers of complications, greater age at onset, and worse acuity at pres entation. (C) 2001 by Elsevier Science Inc. All rights reserved.).