老年人VKH疾病:与成人VKH疾病相比,临床过程的变化
Hrishikesh Kaza1, Navya Cherukuri2, Mudit Tyagi2
1Uveitis and Retina Services, MTC Campus, L V Prasad Eye Institute, Bhubaneshwar, Odisha, India.
Indian journal of ophthalmology
|January 8, 2024
概括
老年患者的Vogt-Koyanagi-Harada (VKH) 疾病在结合类固醇和免疫抑制剂治疗时显示出更好的视觉结果. 然而,免疫抑制剂在这个年龄组引起了显著的并发症.
科学领域:
- 眼科医生 眼科 眼科
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
背景情况:
- 沃格特-科亚纳吉-哈拉达病 (VKH) 是一种罕见的系统性炎症性疾病,影响眼睛和神经系统.
- 关于VKH疾病特征和治疗结果的数据有限,特别是在老年人群中.
研究的目的:
- 确定50岁以上患者VKH疾病的临床特征和治疗结果.
- 评估不同治疗方案在这个人群中的有效性和安全性.
主要方法:
- 从两个印度转诊中心对69名 (>50岁) 患有VKH疾病的患者进行了回顾性分析.
- 收集的数据包括人口统计,眼睛/外眼表现,治疗策略,并发症和视力敏度.
- 根据VKH疾病标准 (可能,不完整,完整) 将患者分类.
主要成果:
- 队列 (平均年龄为56.4岁) 呈现出常见的VKH症状,如神经感官分离和"日落闪光" fundus.
- 与单独使用类固醇相比,联合类固醇和免疫抑制剂治疗显著改善了最佳校正视敏度 (BCVA).
- 显著的比例的患者 (24.6%) 患有或恶化的糖尿病在皮质类固醇,和11.6%经历了免疫抑制药物并发症.
结论:
- 老年VKH患者可能出现较少的全身症状,但需要谨慎管理.
- 同时使用类固醇和免疫抑制剂在患有VKH的老年人中提供了更好的视觉预后.
- 治疗策略必须平衡疗效与老年VKH患者剂量限制并发症的风险增加.
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