Vogt-Koyanagi-Harada Syndrome in a Canadian First Nations Population

Area of Science:

• Ophthalmology
• Immunology
• Genetics

Background:

• Vogt-Koyanagi-Harada (VKH) syndrome is a multisystem inflammatory disorder.
• Uveitis is a common manifestation of VKH syndrome.
• Understanding VKH presentations in diverse populations is crucial for effective management.

Purpose of the Study:

• To characterize the clinical presentations, characteristics, and outcomes of uveitis in Canadian First Nations patients with Vogt-Koyanagi-Harada (VKH) syndrome.
• To identify demographic and disease-specific factors influencing VKH uveitis in this population.

Main Methods:

• Retrospective chart review of 27 Canadian First Nations patients diagnosed with VKH uveitis.
• Data collected included demographics, disease classification (complete, incomplete, probable VKH), systemic associations, management strategies, and visual outcomes.
• Visual acuity changes and rates of immunomodulatory therapy (IMT) use were analyzed.

Main Results:

• The study population comprised 27 patients, predominantly female (96.3%), with an average age of onset at 30.9 years.
• Systemic associations were frequent, including integumentary (70%), neurologic (63%), and auditory (48%) findings.
• Significant vision loss occurred in 42.6% of eyes at presentation, with a slight improvement in final outcomes. Immunomodulatory therapy use was below target rates (37%).

Conclusions:

• Vogt-Koyanagi-Harada (VKH) syndrome can lead to severe uveitis in the First Nations population.
• Comorbidities such as tuberculosis and diabetes, alongside cultural and geographic factors, necessitate tailored and complex management approaches.
• Further research is needed to optimize treatment strategies for VKH uveitis in this demographic.