"Vogt-Koyanagi-Harada disease in pediatric, adult and elderly: clinical characteristics and visual outcomes"

作者全名："Yang, Peizeng; Liao, Weiting; Pu, Yanlin; Zhong, Zhenyu; Wang, Hongmiao; Yu, Qiuyue; Cai, Jinyu; Wang, Wujiao; Su, Guannan"

作者地址："[Yang, Peizeng; Liao, Weiting; Pu, Yanlin; Zhong, Zhenyu; Wang, Hongmiao; Yu, Qiuyue; Cai, Jinyu; Wang, Wujiao; Su, Guannan] Chongqing Med Univ, Affiliated Hosp 1, Chongqing Eye Inst, Chongqing Branch,Municipal Div,Natl Clin Res Ctr O, Youyi Rd 1, Chongqing 400016, Peoples R China"

通信作者："Yang, PZ (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Chongqing Eye Inst, Chongqing Branch,Municipal Div,Natl Clin Res Ctr O, Youyi Rd 1, Chongqing 400016, Peoples R China."

来源：GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000968690400001

JCR分区：Q2

影响因子：2.4

年份：2023

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

关键词：Vogt-Koyanagi-Harada disease; Uveitis; Pediatric; Elderly

摘要："PurposeTo depict a whole spectrum of clinical feartures and visual prognosis among pediatric, adult, and elderly Vogt-Koyanagi-Harada disease (VKH) patients.MethodsRetrospective chart review was conducted in 2571 VKH patients diagnosed from April 2008 to January 2022. Based on age of disease onset, patients were divided into pediatric (age <= 16 years), adult (16 < age < 65 years), and elderly (age >= 65 years) VKH group. Ocular and extraocular manifestations were compared among these patients. Visual outcomes and complications were evaluated using logistic regression models and restricted cubic splines analysis.ResultsThe median follow-up time was 48 (IQR, 12-60) months. Pediatric, adult and elderly VKH were found in 106 (4.1%), 2355 (91.6%), and 110 (4.3%) patients, respectively. All of the patients showed similar ocular manifestations in the context of disease phasing. The proportion of neurological and auditory manifestations in pediatric (42.3% and 7.5%) VKH patients was significantly lower than that in adults (66.5% and 47.9%) and elderly (68.2% and 50%) (both p < 0.0001). An increased risk of macular abnormalities was seen in adults (OR, 3.43; 95% CI, 1.62-7.29) compared with elderly VKH. An inverted-U-shaped pattern was observed between disease onset age and a poor visual outcome (visual acuity 6/18 or worse) according to OR value in VKH patients. The highest risk of BCVA <= 6/18 was observed in 32 years at disease onset (OR, 1.51; 95% CI, 1.18-1.94). A higher risk of visual loss was observed in adult VKH patients (OR, 9.06; 95% CI, 2.18-37.6) compared with elderly VKH patients. And stratified by macular abnormalities, the interaction test was not significant (P = 0.634).ConclusionOur study identified, for the first time, a whole spectrum of clinical features of VKH based on a large cohort of Chinese patients. Adult VKH patients have an increased risk of poor visual outcomes, possibly due to increased frequency of macular abnormalities."

基金机构：National Natural Science Foundation Key Program [81930023]; Chongqing Outstanding Scientists Project; Chongqing Chief Medical Scientist Project; Key Project of Chongqing Science and Technology Bureau [CSTC2021jscx-gksb-N0010]; Chongqing Science & Technology Plat-form and Base Construction Program [cstc2014pt-sy10002]; Chongqing Key Laboratory of Ophthalmology (CSTC) [2008CA5003]

基金资助正文："This work was supported by National Natural Science Foundation Key Program (81930023), Chongqing Outstanding Scientists Project (2019), Chongqing Chief Medical Scientist Project (2018), Key Project of Chongqing Science and Technology Bureau (CSTC2021jscx-gksb-N0010), Chongqing Science & Technology Plat-form and Base Construction Program (cstc2014pt-sy10002) Chongqing Key Laboratory of Ophthalmology (CSTC, 2008CA5003)"