Vogt-Koyanagi-Harada disease in First Nations and Métis of Northern Alberta

The objective of this article was to describe the incidence, clinical characteristics, and visual outcomes of Vogt-Koyanagi-Harada disease in First Nations and Métis individuals.

A retrospective chart review.

Nineteen First Nation and Métis Canadian residents in Northern Alberta.

Electronic records for a 17-year period (1994-2010) were reviewed. Charts were reviewed for age, sex, length of follow-up, location of primary residence, diagnostic criteria at presentation, disease stage at presentation, duration of symptoms before presentation, ocular and extraocular manifestations at presentation, treatments, compliance, and complications. The time to an eye reaching 20/40, 20/200, and a halving of the baseline visual angle was plotted using Kaplan-Meier methodology.

Of 19 First Nations and Métis individuals identified, 84.2% were female, and the average age at presentation was 30.8 years. The most common presenting symptom and sign were blurred vision (89.5%) and anterior segment inflammation (89.5%), respectively. Fifteen (78.9%) patients had extraocular manifestations, the most common being alopecia (26.3%) and cerebrospinal fluid pleocytosis (26.3%). All patients were initially treated with corticosteroids; immunomodulatory therapy was used for 2 (10.5%) patients. Twelve (63.2%) patients experienced ocular complications; 47.4% of patients had difficulty with treatment compliance and attending follow-up appointments. The median time to achieve 20/40 vision was shorter for compliant patients compared with noncompliant patients (P = 0.048).

The features of Vogt-Koyanagi-Harada disease in First Nations and Métis Canadians are most similar to series of South Asian and Hispanic patients. Compliant patients were found to achieve 20/40 vision significantly sooner than noncompliant patients.