Vogt-Koyanagi-Harada syndrome

Area of Science:

• Ophthalmology
• Immunology

Background:

• Vogt-Koyanagi-Harada syndrome (VKH) is an idiopathic, bilateral, granulomatous inflammatory disease affecting ocular and sometimes neurological tissues.
• VKH is more prevalent in individuals of Oriental, Native American, Middle Eastern, and Hispanic ancestries.

Purpose of the Study:

• To describe the clinical characteristics, management, and visual outcomes of Vogt-Koyanagi-Harada syndrome in a cohort of patients.
• To investigate potential associations between VKH and specific demographic factors, comorbidities, and pregnancy.

Main Methods:

• Retrospective analysis of 20 patients diagnosed with Vogt-Koyanagi-Harada syndrome.
• Review of patient records for demographic data, clinical presentation, treatment, and visual acuity.

Main Results:

• Vogt-Koyanagi-Harada syndrome represented 3.7% of referred uveitis cases, with a notable link to American Indian ancestry.
• Five patients experienced forme fruste retinal detachment, which resolved in 2-3 months with corticosteroid treatment, though anterior inflammation persisted chronically.
• Retinal vasculitis was observed in seven patients; pregnancy appeared to have a beneficial effect on disease activity.
• Comorbidities like diabetes mellitus and sickle cell hemoglobin did not adversely affect outcomes.
• Good visual outcomes were achieved, with 16 out of 20 patients maintaining a visual acuity of 6/21 (20/70) or better in at least one eye.

Conclusions:

• Vogt-Koyanagi-Harada syndrome requires prompt management, particularly for retinal detachments, with corticosteroids being effective.
• Chronic anterior inflammation is a common sequela, necessitating long-term monitoring and management.
• Pregnancy may exert a protective effect on disease activity in VKH patients.
• Visual prognosis for Vogt-Koyanagi-Harada syndrome is generally favorable with appropriate treatment.