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

To characterize presentations, characteristics and outcomes of uveitis in Vogt-Koyanagi-Harada (VKH) syndrome in a North American First Nations (FN) population.

Charts of 27 Canadian FN patients with VKH uveitis were retrospectively reviewed to characterize demographics, disease characteristics, management, complications and visual outcomes.

Average age at uveitis onset was 30.9 ± 13.8 years. Twenty-six patients 10 (96.3%) were female. Nine patients (33.3%) demonstrated complete VKH, 8 (29.6%) incomplete, and 10 (37%) probable VKH. Systemic associations included integumentary (19 patients, 70%), neurologic (17 patients, 63%), and auditory (13 patients, 48%) findings. Initial rates of mild, moderate and severe vision loss were 19 eyes (35.2%), 12 eyes (22.2%), and 23 eyes (42.6%), respectively, compared with final rates of 19 eyes (35.2%), 14 eyes (25.6%) and 21 eyes (38.9%), respectively. Average change in visual acuity was 15 0.1 ± 6.3 Snellen lines. Rates of immunomodulatory therapy (IMT) use (10 patients, 37%) fell short of targets.

VKH may cause potentially severe uveitis in this population. Comorbidities including tuberculosis and diabetes, in addition to unique cultural, linguistic and geographic factors, may necessitate complex, individualized management strategies.