Abstract

CLINICAL PROFILE OF VOGT-KOYANAGI-HARADA SYNDROME IN A TERTIARY EYE CARE CENTRE

Author(s): Latha Hariharan1, Arthi Mohankumar2

BACKGROUND
Vogt-Koyanagi-Harada syndrome is a granulomatous panuveitis with multisystemic manifestations. It is characterised by exudative retinal detachments, cutaneous and neurological manifestations. The main aim of this study is to document the epidemiological features, diverse clinical manifestations, angiographic and optical coherence tomography and characteristics of VKH disease.
MATERIALS AND METHODS
20 patients who were diagnosed as Vogt-Koyanagi-Harada syndrome were included in the study after applying appropriate inclusion and exclusion criteria were included in the study.
RESULTS
20 patients were included in the study, which included 18 females (90%) and 2 males (10%). The mean age of the study population was 39.21 years. All patients presented with complaints of defective vision, 17 patients (85%) had bilateral loss of vision and 3 patients (15%) had unilateral defective vision. One patient (5%) had poliosis and vitiligo and one patient (5%) had alopecia. The mean Best Corrected Visual Acuity (BCVA) at presentation was 1.33 LogMAR units. The mean post-treatment BCVA was 0.28 LogMAR units. The improvement in visual acuity following treatment was found to be statistically significant with a ‘p’ value <0.05. 17 patients (85%) presented with bilateral exudative retinal detachment. 26 eyes (70.27%) showed extensive exudative retinal detachment. 10 eyes (27.02%) showed multifocal exudative retinal detachment. All patients were treated with systemic corticosteroids resulting in decrease in inflammation and resolution of exudative retinal detachments. Patients whose inflammation was refractory to systemic corticosteroids were treated with immunosuppressants, namely azathioprine (1 patient, 5%).
CONCLUSION
In summary, Vogt-Koyanagi-Harada disease is a bilateral, diffuse, granulomatous uveitis associated with vitiligo, poliosis, alopecia, central nervous system and auditory signs, which responds to appropriate systemic steroid therapy.