Multi-centre causes of vision loss and clinical outcomes over an 18 year period in patients with VKH
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Purpose
To determine the factors that predict vision loss and treatment outcomes of VKH disease over an 18-year period.
Methods
Patients diagnosed with VKH between January 1999 to April 2017 who were seen for at least 6 months were identified.
Results
127 patients (254 eyes) were diagnosed with VKH, of which 101 were female (80%). Mean baseline best-corrected visual acuity (BCVA) was 0.38 logMAR, 1 year 0.22, 5 years 0.24 and 10 years 0.4 logMar. Overall, the patient cohort had a significant improvement in baseline verse final visual outcome (p=.02). Thirteen eyes (6%) were defined as having moderate visual loss (MVL; ≤20/50) and 32 eyes (14.7%) had severe visual loss (SVL;≤20/200). Recurrent episodes occurred in 87 (54%) patients and the mean time to recurrence was 638.5 days. Recurrences were 2.69 per person per year and in moderate vision loss (MVL) or severe vision loss (SVL) were 0.16 per person/year (0.32 eye years). Fifty-eight patients (45.7%) required additional immunosuppression.
Conclusion
The majority of eyes had a good visual outcome and patients diagnosed with probable VKH had the most significant improvement in vision between presentation and final review. Kaplan Meier survival analysis showed vision loss occurred mainly during the first two years. There were a large number of recurrences in this young population group with close to half the patients requiring secondary immunosuppression. Therefore VKH requires aggressive immunosuppression early so as to decrease risk of vision loss
Conflict of interest
No
Author 1
Last name
ZAGORA
Initials of first name(s)
SL
Department
Discipline of Ophthalmology, University of Sydney
City
Sydney
Country
Australia
Author 2
Last name
Tomkins-Netzer
Initials of first name(s)
O
Department
Bnai Zion Medical Center
City
Haifa
Country
Israel
Author 3
Last name
Lightman
Initials of first name(s)
S
Department
Ophthalmology UCL
City
London
Country
Australia
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