First Author: M.Jhingan INDIA
Co Author(s): M. Tyagi C. Videkar A. Mathai R. Reddy Pappuru
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To assess clinical presentations and outcomes of VKH in paediatric population(defined as <18 years)
L.V. Prasad Eye Institute, Hyderabad
Retrospective observational case series of 68 eyes of 34 patients diagnosed with VKH on the basis of clinical signs and appropriate investigations (FFA and B scan) wherever possible observed over a period of 30 years
Mean presenting age was 14.05 ± 2.662 years (R- 8 to 18 years) with female preponderance (76.47%). All cases were bilateral with a mean follow-up of 38.33 ± 30.29 months. Mean presenting visual acuity was LogMAR 1.148 ± 1.139 (Snellen’s 20/281), improving to 0.518 ± 1.11 (Snellens’ 20/66) at the last visit. 24 patients (70.58%) had anterior segment inflammation, 19 patients had vitritis (55.88%). 23 patients (60.52%) presented with acute loss of vision. 9 patients (26.47%) had cataract bilaterally and 5 patients (14.7%) had raised IOP. 23(67.64%) patients had bilateral serous retinal detachments and two had unilateral. One eye had CNVM whereas one eye had band shaped keratopathy at presentation. 21 patients (61.76%) received intravenous methylprednisolone. 33 patients (97.05%) received oral steroids. 22 patients (64.7%) received long term immunosuppressants. 4 eyes (5.88%) received intravitreal triamcinolone acetonide. Mean duration of treatment with steroids was 15.06 ± 18.736 months and immunosuppressants was 17.61 ± 18.82 months.
Paediatric VKH has myriad presentations with many patients presenting with chronic sequelae. Anterior segment complication rate was quite high. Long term steroids and immunosuppression are needed to prevent recurrences and chronic complications.