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TitleMulti-centre causes of vision loss and clinical outcomes over an 18 year period in patients with VKH
Accept poster if oral is not possible ?Yes
PurposeTo determine the factors that predict vision loss and treatment outcomes of VKH disease over an 18-year period.
MethodsPatients diagnosed with VKH between January 1999 to April 2017 who were seen for at least 6 months were identified.
Results127 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.
ConclusionThe 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 interestNo
Author 1
Last nameZAGORA
Initials of first name(s)SL
DepartmentDiscipline of Ophthalmology, University of Sydney
CitySydney
CountryAustralia
Author 2
Last nameTomkins-Netzer
Initials of first name(s)O
DepartmentBnai Zion Medical Center
CityHaifa
CountryIsrael
Author 3
Last nameLightman
Initials of first name(s)S
DepartmentOphthalmology UCL
CityLondon
CountryAustralia