Skip to main content
Top
Published in: International Ophthalmology 2-3/2007

01-06-2007 | Original Paper

The spectrum of Vogt-Koyanagi-Harada disease in Tunisia, North Africa

Authors: Moncef Khairallah, Sonia Zaouali, Riadh Messaoud, Sami Chaabane, Sonia Attia, Salim Ben Yahia, Kamel Hmidi

Published in: International Ophthalmology | Issue 2-3/2007

Login to get access

Abstract

Objective To analyze the clinical profile of Vogt-Koyanagi-Harada (VKH) disease in Tunisia, North Africa.
Methods We retrospectively reviewed the clinical records of 49 patients diagnosed with VKH disease at the Department of Ophthalmology of Fattouma Bourguiba University Hospital, Monastir, Tunisia, between January 1994 and September 2005.
Results Of all the uveitis cases diagnosed during the study period, VKH disease was the fourth most commonly occurring type (7.4%). Thirty-two patients (65.3%) were female, and 17 patients (34.7%) were male. The mean age at disease onset was 35 years (range: 16–54 years). The majority of patients (51%) had probable VKH disease, followed by incomplete type (47%); only 2% had the complete type. At presentation, 47 patients (96%) had bilateral ocular involvement. Clinical presentation was a panuveitis in 25 patients (51%) and a posterior uveitis in 24 patients (49%). Visual acuity (VA) at presentation ranged from less than 20/200 (40.8%) to more than 20/40 (28.5%). All patients were treated with systemic corticosteroids for 2–19 months (mean: 10.5 months). Four patients (8%) were treated with cyclosporin because of serious systemic side effects of corticosteroids. Complications included cataract in 18 eyes (33.9%), glaucoma in nine eyes (16.96%) and choroidal neovascularization in one eye (1%). Fifty-eight eyes (59%) had a final VA of 20/40 or better. Factors associated with a poor VA at the final follow-up were the presence of a poor VA at presentation (P = 0.02), the occurrence of complications (P  = 0.001) and/or recurrences (P = 0.02).
Conclusion In Tunisia, VKH disease is a common cause of uveitis that predominantly affects young women. The overwhelming majority (98%) have probable or incomplete VKH disease, presenting as panuveitis or posterior uveitis. More than 50% of patients undergoing treatment with corticosteroids will maintain a VA of 20/40 or better.
Literature
1.
2.
go back to reference Khairallah M, Yahia SB, Ladjimi A, Messaoud R et al (2006) Pattern of uveitis in a referral center in Tunisia, North Africa. Eye 2006:1–7 Khairallah M, Yahia SB, Ladjimi A, Messaoud R et al (2006) Pattern of uveitis in a referral center in Tunisia, North Africa. Eye 2006:1–7
3.
go back to reference Read RW, Holland GN, Rao NA et al (2001) Revised diagnostic criteria for Vogt-Koyanagi-Harada disease: report of an international committee on nomenclature. Am J Ophthalmol 131:647–652PubMedCrossRef Read RW, Holland GN, Rao NA et al (2001) Revised diagnostic criteria for Vogt-Koyanagi-Harada disease: report of an international committee on nomenclature. Am J Ophthalmol 131:647–652PubMedCrossRef
4.
go back to reference Mondkar SV, Biswas J, Ganesh SK (2000) Analysis of 87 cases with Vogt-Koyanagi-Harada disease. Jpn J Ophthalmol 44:296–301PubMedCrossRef Mondkar SV, Biswas J, Ganesh SK (2000) Analysis of 87 cases with Vogt-Koyanagi-Harada disease. Jpn J Ophthalmol 44:296–301PubMedCrossRef
5.
6.
go back to reference Read RW, Rao NA, Cunningham ET (2000) Vogt-Koyanagi-Harada disease. Curr Opin Ophthalmol 11:437–442PubMedCrossRef Read RW, Rao NA, Cunningham ET (2000) Vogt-Koyanagi-Harada disease. Curr Opin Ophthalmol 11:437–442PubMedCrossRef
7.
go back to reference Belfort Junior R, Nishi M, Hayashi S et al (1988) Vogt-Koyanagi-Harada's disease in Brazil. Jpn J Ophthalmol 32:344–347PubMed Belfort Junior R, Nishi M, Hayashi S et al (1988) Vogt-Koyanagi-Harada's disease in Brazil. Jpn J Ophthalmol 32:344–347PubMed
8.
go back to reference Bykhovskaya I, Thorne JE, Kempen JH et al (2005) Vogt-Koyanagi-Harada disease: clinical outcomes. Am J Ophthalmol 140:674–678PubMed Bykhovskaya I, Thorne JE, Kempen JH et al (2005) Vogt-Koyanagi-Harada disease: clinical outcomes. Am J Ophthalmol 140:674–678PubMed
9.
go back to reference Tabbara KF, Chavis PS, Freeman WR (1998) Vogt-Koyanagi-Harada syndrome in children compared to adults. Acta Ophthalmol Scand 76:723–726PubMedCrossRef Tabbara KF, Chavis PS, Freeman WR (1998) Vogt-Koyanagi-Harada syndrome in children compared to adults. Acta Ophthalmol Scand 76:723–726PubMedCrossRef
10.
go back to reference Rathinam SR, Vijayalakshmi P, Namperumalsamy P et al (1998) Vogt-Koyanagi-Harada syndrome in children. Ocul Immunol Inflamm 6:155–161PubMedCrossRef Rathinam SR, Vijayalakshmi P, Namperumalsamy P et al (1998) Vogt-Koyanagi-Harada syndrome in children. Ocul Immunol Inflamm 6:155–161PubMedCrossRef
11.
go back to reference Touitou V, Escande C, Bodaghi B et al (2005) Diagnostic and therapeutic management of Vogt-Koyanagi-Harada syndrome. J Fr Ophtalmol 28:9–16PubMed Touitou V, Escande C, Bodaghi B et al (2005) Diagnostic and therapeutic management of Vogt-Koyanagi-Harada syndrome. J Fr Ophtalmol 28:9–16PubMed
12.
go back to reference Beniz J, Forster DJ, Lean JS et al (1991) Variations in clinical features of the Vogt-Koyanagi-Harada syndrome. Retina 11:275–280PubMedCrossRef Beniz J, Forster DJ, Lean JS et al (1991) Variations in clinical features of the Vogt-Koyanagi-Harada syndrome. Retina 11:275–280PubMedCrossRef
13.
go back to reference Ohno SMR, Matsuda H (1988) Clinical studies on Vogt-Koyanagi-Harada disease. Jpn J Ophthalmol 32:334–343PubMed Ohno SMR, Matsuda H (1988) Clinical studies on Vogt-Koyanagi-Harada disease. Jpn J Ophthalmol 32:334–343PubMed
14.
go back to reference Bouchenaki NHC (2001) The contribution of indocyanine green angiography to the appraisal and management of Vogt-Koyanagi-Harada Disease. Ophthalmology 108:54–64PubMedCrossRef Bouchenaki NHC (2001) The contribution of indocyanine green angiography to the appraisal and management of Vogt-Koyanagi-Harada Disease. Ophthalmology 108:54–64PubMedCrossRef
15.
go back to reference Nakamura S, Nakazawa M, Yoshioka M et al (1996) Melanin-laden macrophages in cerebrospinal fluid in Vogt-Koyanagi-Harada syndrome. Arch Ophthalmol 114:1184–1188PubMed Nakamura S, Nakazawa M, Yoshioka M et al (1996) Melanin-laden macrophages in cerebrospinal fluid in Vogt-Koyanagi-Harada syndrome. Arch Ophthalmol 114:1184–1188PubMed
16.
go back to reference Rubsamen PE, Gass JD (1991) Vogt-Koyanagi-Harada Syndrome: clinical course, therapy and long-term visual outcome. Arch Ophthalmol 109:682–687 Rubsamen PE, Gass JD (1991) Vogt-Koyanagi-Harada Syndrome: clinical course, therapy and long-term visual outcome. Arch Ophthalmol 109:682–687
17.
go back to reference Paredes I, Ahmed M, Foster CS (2006) Immunomodulatory therapy for Vogt-Koyanagi-Harada patients as first-line therapy. Ocul Immunol Inflamm 14:87–90PubMedCrossRef Paredes I, Ahmed M, Foster CS (2006) Immunomodulatory therapy for Vogt-Koyanagi-Harada patients as first-line therapy. Ocul Immunol Inflamm 14:87–90PubMedCrossRef
18.
go back to reference Yamaki K, Hara K, Sakuragi S (2005) Application of revised diagnostic criteria for Vogt-Koyanagi-Harada disease in Japanese patients. Jpn J Ophthalmol 49:143–148PubMedCrossRef Yamaki K, Hara K, Sakuragi S (2005) Application of revised diagnostic criteria for Vogt-Koyanagi-Harada disease in Japanese patients. Jpn J Ophthalmol 49:143–148PubMedCrossRef
19.
go back to reference Sugiura S (1978) Vogt-Koyanagi-Harada disease. Jpn J Ophthalmol 22:9–35 Sugiura S (1978) Vogt-Koyanagi-Harada disease. Jpn J Ophthalmol 22:9–35
20.
go back to reference Fujioka TFM, Okinami S (1980) A statistic study of Vogt-Koyanagi-Harada syndrome. Acta Soc Ophtalmol Jpn 84:1979–1982 Fujioka TFM, Okinami S (1980) A statistic study of Vogt-Koyanagi-Harada syndrome. Acta Soc Ophtalmol Jpn 84:1979–1982
21.
go back to reference Rao NA (1997) Mechanisms of inflammatory response in sympathetic ophthalmia and VKH syndrome. Eye 11:213–216PubMed Rao NA (1997) Mechanisms of inflammatory response in sympathetic ophthalmia and VKH syndrome. Eye 11:213–216PubMed
22.
go back to reference Read RW, Rechedouni A, Butani N et al (2001) Complications and prognostic factors in Vogt-Koyanagi-Harada disease. Am J Ophthalmol 131:599–606PubMedCrossRef Read RW, Rechedouni A, Butani N et al (2001) Complications and prognostic factors in Vogt-Koyanagi-Harada disease. Am J Ophthalmol 131:599–606PubMedCrossRef
Metadata
Title
The spectrum of Vogt-Koyanagi-Harada disease in Tunisia, North Africa
Authors
Moncef Khairallah
Sonia Zaouali
Riadh Messaoud
Sami Chaabane
Sonia Attia
Salim Ben Yahia
Kamel Hmidi
Publication date
01-06-2007
Publisher
Kluwer Academic Publishers
Published in
International Ophthalmology / Issue 2-3/2007
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI
https://doi.org/10.1007/s10792-006-9013-x

Other articles of this Issue 2-3/2007

International Ophthalmology 2-3/2007 Go to the issue