Clinical and therapeutic features of pediatric Vogt-Koyanagi-Harada disease

Purpose. - To analyze clinical, therapeutic and prognostic features of pediatric Vogt-KoyanagiHarada (VKH) disease. Material and methods. - This retrospective study included 16 eyes of 8 children diagnosed with VKH disease followed at a teaching hospital over a 10 year period. Diagnosis was based on the revised criteria of VKH disease. All data were analyzed using SPSS (R) software. Results. - There were 62.5% girls and 37.5% boys. The mean age (years) was 14.6 +/- 4.4. The mean follow-up (months) was 38.7 +/- 28.7. The mean initial visual acuity (VA) (LogMAR) was 1.4 with 68.8% of eyes presenting with severe visual loss at admission. The median time (days) required for resorption of the serous retinal detachment was 10 [8.25-25]. Extraocular signs were present in 62.5% of cases. The mean time until initiation of treatment was 25.6 days. 62.5% of patients received corticosteroids alone, and 37.5% of patients received a combination of corticosteroids and immunosuppressive therapy. Final VA was 0.4 [0.1-2.3]. In our study, the time until consultation, low initial VA and recurrences were statistically associated with severe visual loss (P <= 0.05). Conclusion. - Life expectancy in pediatric cases of VKH disease justifies the early initiation of immunosuppressive treatment or even biological therapy to achieve better steroid sparing and preserve visual function. (C) 2020 Elsevier Masson SAS. All rights reserved.