Development and Evaluation of Diagnostic Criteria for Vogt-Koyanagi-Harada Disease

Peizeng Yang*, Yuanyuan Zhong, Liping Du, Wei Chi, Ling Chen, Rui Zhang, Meifen Zhang, Hong Wang, Hong Lu, Liu Yang, Wenjuan Zhuang, Yan Yang, Lin Xing, Lei Feng, Zhengxuan Jiang, Xiaomin Zhang, Yuqin Wang, Hui Zhong, Liqiong Jiang, Changlin ZhaoFuzhen Li, Shuang Cao, Xiaoli Liu, Xuan Chen, Yanyun Shi, Weizhong Zhao, Aize Kijlstra

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

47 Citations (Web of Science)

Abstract

IMPORTANCE To our knowledge, a set of well-defined diagnostic criteria is not yet developed for the diagnosis of Vogt-Koyanagi-Harada (VKH) disease. OBJECTIVE To develop and evaluate a set of diagnostic criteria for VKH disease using data from Chinese patients. DESIGN, SETTING, AND PARTICIPANTS This case-control study reviewed medical records of patients from a tertiary referral center between October 2011 and October 2016. Data from 634 patients with VKH disease and 623 patients with non-VKH uveitis from southern China were used to develop the Diagnostic Criteria for VKH Disease (DCV). Data from an additional group of 537 patients with a definite VKH disease diagnosis and 525 patients with non-VKH uveitis from northern China were used to evaluate the diagnostic criteria. MAIN OUTCOMES AND MEASURES Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and receiver operating characteristic. RESULTS Of the 1257 patients used to construct the DCV, 665 (52.9%) were male, and the mean (SD) age at disease onset was 38.6 (13.6) years. The 3-class model and 21 clinical findings were selected by latent class analysis. Variables with a high positive rate in the early-phase or late-phase VKH group or high specificity constituted essential parameters. Constellations of these essential parameters constructed the DCV. The sensitivity and NPV of the DCV were higher than those of the Revised Diagnostic Criteria for VKH Disease (RDC) (sensitivity: 94.6% vs 71.9%; difference, 22.7%; 95% CI, 18.5-27.0; NPV: 94.3% vs 76.6%; difference, 17.7%; 95% CI, 13.9-21.5). The specificity and PPV of the DCV were not different from that of the RDC (specificity: 92.2% vs 93.9%; difference, 1.7%; 95% CI, -1.4 to 4.8; PPV: 89.3% vs 92.3%; difference, 3.0%; 95% CI, -1.4 to 4.8). The area under the receiver operating characteristic curve of the DCV and the RDC were 0.934 (95% CI, 0.917-0.951) and 0.829 (95% CI, 0.803-0.855), respectively. CONCLUSIONS AND RELEVANCE The DCV were developed and evaluated using data from Chinese patients with VKH disease and showed a high sensitivity, NPV, and area under the receiver operating characteristic curve in comparison with the RDC. However, they were developed using a retrospective analysis and should be evaluated in prospective studies in other racial/ethnic populations.
Original languageEnglish
Pages (from-to)1025-1031
Number of pages7
JournalJAMA Ophthalmology
Volume136
Issue number9
DOIs
Publication statusPublished - 1 Sep 2018

Keywords

  • INDOCYANINE GREEN ANGIOGRAPHY
  • CLASSIFICATION CRITERIA
  • CHOROIDAL THICKNESS
  • MANAGEMENT
  • UVEITIS
  • PATIENT
  • UTILITY

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