Wow, and again it slipped to the end of the day. I WILL keep this resolution, goshdarnit.
Question the study is trying to answer: do we _really_ have to LP these people if they just have the characteristic ocular findings?
Study design: chart review of 116 patients with VKH
Results: only 10 patients were identified who had had LP; all 10 were Hispanic. 9 had had at least a headache, with varying other meningeal or auditory signs. 8 had abnormal CSF (6 with pleocytosis, 1 with “few WBC”, and 1″abnormal”, not specified further).
Basically, the authors don’t love the spinal tap based on it being somewhat nonspecific and claiming the risks outweigh the benefits since the diagnosis can be essentially confirmed with ocular testing. I think this paper got cited a bunch elsewhere because I kept reading a statistic that “80%” had CSF pleocytosis, but 8/10 is not so very impressive, especially since it was such a small fraction of their VKH cohort.