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Vogt-Koyanagi-Harada disease in children

A M Abu El-Asrar1, A S Al-Kharashi, H Aldibhi

  • 1Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia. abuasrar@ksu.edu.sa

Eye (London, England)
|May 5, 2007
PubMed

Insights

Early treatment improves visual outcomes in pediatric Vogt-Koyanagi-Harada (VKH) disease, a form of uveitis. Prompt intervention and careful corticosteroid management are key prognostic factors for favorable vision in children with VKH disease.

Area of Science:

  • Ophthalmology
  • Pediatric uveitis
  • Autoimmune diseases

Background:

  • Vogt-Koyanagi-Harada (VKH) disease is a multisystem inflammatory disorder affecting the eyes, central nervous system, and auditory and integumentary systems.
  • Pediatric VKH disease presents unique challenges in diagnosis and management due to its rarity and potential for long-term visual impairment.

Purpose of the Study:

  • To identify key prognostic factors influencing the visual outcome in children diagnosed with Vogt-Koyanagi-Harada (VKH) disease.
  • To elucidate the relationship between clinical presentation, treatment strategies, and disease progression in pediatric VKH patients.

Main Methods:

  • Retrospective review of pediatric patients (16 years and younger) diagnosed with acute uveitis secondary to VKH disease between 1999 and 2006.
  • Analysis of patient demographics, clinical findings at presentation, treatment regimens, complications, recurrence, and final visual acuity.

Main Results:

  • A total of 23 children (87% female) were included, with a mean age of 12.5 years and a mean follow-up of 48.6 months.
  • 82.6% of eyes achieved a final visual acuity of 20/40 or better. Complications occurred in 11 eyes, with cataract and glaucoma being most common.
  • Shorter interval from symptom onset to treatment predicted better visual acuity (20/20). Disease recurrence was associated with complications, worse vision, and specific treatment parameters.

Conclusions:

  • The visual prognosis for pediatric Vogt-Koyanagi-Harada (VKH) disease is generally favorable with appropriate management.
  • Factors such as initial clinical findings, treatment delay, disease recurrence, and corticosteroid tapering strategies significantly impact visual outcomes.
  • Prompt initiation of treatment and judicious management of systemic corticosteroids are crucial for preserving vision in children with VKH disease.
Abstract

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