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Retina. 2010 Jul-Aug;30(7):1113-21. doi: 10.1097/IAE.0b013e3181c96a87.

Prevalence, clinical characteristics, and causes of vision loss in children with Vogt-Koyanagi-Harada disease in South India.

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Department of Ophthalmology, California Pacific Medical Center, San Francisco, California, USA.



The purpose of this study was to describe the prevalence, clinical characteristics, and causes of vision loss in children with Vogt-Koyanagi-Harada disease seen at a uveitis referral center in South India.


Charts of patients with Vogt-Koyanagi-Harada disease examined in the uveitis referral clinic of Aravind Eye Hospital between January 1998 and December 2007 were reviewed. A subset of patients <or=16 years of age was identified, and the clinical characteristics and causes of vision loss were evaluated.


Vogt-Koyanagi-Harada disease was diagnosed in 267 of 22,959 patients (1.2%) during the study period. Twenty-two children (8.2%) were identified, including 13 girls (59.1%) and 9 boys (40.9%). Age at presentation ranged from 8 years to 16 years, with a mean and a median of 12.6 and 13.5 years, respectively. The most common complaints were blurred vision (39 eyes, 88.6%) and eye redness (36 eyes, 81.8%). Fifteen (68.5%) children had headaches, 6 (27.3%) developed meningismus and alopecia, 4 (18.2%) developed poliosis and vitiligo, and 3 (13.6%) had tinnitus or dysacusis. Initially, all were treated with oral prednisone, but 12 (54.6%) required methotrexate, 5 (22.7%) required azathioprine, and 2 (9.1%) required cyclophosphamide. Seventy-five percent of eyes had a final visual acuity of >or=20/40, whereas 13.6% had a final visual acuity of <or=20/200.


Vogt-Koyanagi-Harada disease is an uncommon cause of uveitis in children. The clinical characteristics of pediatric Vogt-Koyanagi-Harada disease in South India resembled those described in cohorts from other regions. Although children in our cohort tended to do well with prompt diagnosis and treatment, long-term vision loss can occur.

[Indexed for MEDLINE]

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