Acquired myopia in Vogt-Koyanagi-Harada disease

To analyze the change in refractive error and the axial length of chronic Vogt-Koyanagi-Harada (VKH) disease.

Medical records of 106 eyes of 54 adult VKH patients were analyzed. The refractive error and the axial length were compared between the baseline (defined as the time point at least 2 weeks after acute stage of VKH) and the final visit. The rate of the eyes with significant myopia progression [defined as refraction change toward myopia > 1 diopter (D)] was examined. The correlation of the degree of sunset glow fundus/choroidal thickness with the change in refractive error was also evaluated.

At the final visit, the mean refractive error was more myopic and the axial length was longer than at baseline. Seventeen of the 106 eyes (16.0%) showed significant myopia progression. The mean change in refractive error during a follow-up in these 17 eyes was - 2.7 D (range - 7.5 to - 1.1 D). The axial length data both at baseline and at the final visit were obtained only in 8 eyes. The mean change in axial length during a follow-up in these 8 eyes was 1.3 mm (range 0-3.7 mm). In the cases with myopia progression, sunset glow fundus was more frequent and subfoveal choroid was thinner than those without myopia progression.

Myopia progression as well as increase in axial length occurs in VKH disease. The link between choroidal thinning and axial length elongation in VKH patients gives some insights into axial length increase of pathologic myopia.