Optic disc swelling in Vogt-Koyanagi-Harada disease

This retrospective observational study was designed to evaluate the frequency of, and the factors associated with, optic disc swelling in Vogt-Koyanagi-Harada disease (VKH).

A retrospective observational study was conducted. We analyzed 116 eyes of 58 patients with VKH. Demographic and clinical differences between patients with and without disc swelling were analyzed.

Thirty-two eyes (27.6%) of 16 VKH patients had disc swelling. The mean age of the patients with disc swelling was higher than that of those without disc swelling (58.9 vs. 41.4, P = 0.0001). The disc-macula distance to disc diameter (DM/DD) ratio of the eyes with disc swelling was higher than that of those without disc swelling (2.81 vs. 2.59, P = 0.0007). The cup to disc (C/D) ratio of the eyes with disc swelling was smaller than that of those without disc swelling (0.18 vs. 0.32, P = 0.000001). The intraocular pressure was lower (P = 0.0084), and the refractive error was larger (P = 0.019), in eyes with disc swelling than in those without. There was no significant association between the presence of disc swelling and the range of retinal detachment, cerebrospinal fluid cell count, recurrence rate of VKH, or the incidence of sunset glow fundus. Among the eyes with disc swelling, 13 eyes of 7 patients had visual field defects even after the inflammation subsided, and these patients were older, had a higher DM/DD ratio, and had a smaller C/D ratio than those without visual field defects.

The occurrence of disc swelling in VKH was significantly correlated with age and disc morphology, rather than the severity of inflammation. Some VKH patients with disc swelling develop visual field defects from optic disc involvement.