Vogt-Koyanagi-Harada Disease in Paediatric Population: Case Series and Literature Review

Vogt-Koyanagi-Harada (VKH) is a multisystem autoimmune disorder affecting the eyes, central nervous system, ears, and skin. VKH accounts for approximately 0.4% to 1.7% of paediatric uveitis cases. This case series aims to describe seven paediatric VKH cases with markedly different courses, with the oldest presenting at 17 years old and the youngest at 3 years old, all followed at a tertiary eye care centre, and to review current paediatric VKH literature. Consistent with previous reports, this series shows a female predominance. Two cases involved systemic symptoms; one patient experienced a headache, and another exhibited skin involvement. All cases presented during the acute uveitic phase. One eye required vitreoretinal surgery due to severe exudative detachment and vitritis. Four cases had glaucoma in eight eyes, and one eye underwent tube shunt surgery due to refractory glaucoma. Cataract surgery was performed on three eyes across two cases. Cataract and glaucoma were the most common complications in this series, aligning with prior studies. In 4 of 7 cases, rapid treatment with adalimumab in addition to conventional therapy was achieved. The literature suggests that adalimumab is an effective and safe option for VKH refractory to standard treatments. Therefore, this medication may be recommended for paediatric patients who might have a potentially poor prognosis.