Vogt-Koyanagi-Harada Disease: The Clinical Spectrum and Management of Case Series in a Tertiary Eye Centre in Northern Part Of Malaysia
Authors:
Atiqah Nur Hasan 1,2; Mushawiahti Mustapha 2; Haslina Abdul Halim Wan Wan 2
Authors‘ workplace:
Department of Ophthalmology, Hospital Sultanah Bahiyah, Malaysia
1; Department of Ophthalmology, Faculty of Medicine, University, Kebangsaan Malaysia Medical Center, Malaysia
2
Published in:
Čes. a slov. Oftal., 80, 2024, No. 3, p. 140-144
Category:
Original Article
doi:
https://doi.org/10.31348/2024/1
Overview
Aims: We present the clinical spectrum, the initial clinical presentation with management trends in treating 14 Vogt-Koyanagi-Harada (VKH) disease cases in a tertiary center in the Northern part of Malaysia.
Case series: There were 14 cases of Vogt-Koyanagi-Harada (VKH) disease retrospectively reviewed over five years (from 2015 to 2020). The mean age at presentation was 37.7 years (range 21–64 years), with female predominance (85.7%). All cases presented with acute uveitic stage and bilateral eye involvement. Of them, 11 (78.6%) were probable VKH, and three (21.4%) were incomplete VKH. All patients attended with acute panuveitis at first presentation. The main posterior segment involvement was disc edema in 57.1% (16 out of 28 eyes) and exudative retinal detachment (ERD) in 35.7% (10 out of 28 eyes). Most of them presented with blindness (3/60 and worse) and moderate visual impairment (6/18–6/60); 35.71% each, followed by mild visual impairment (6/12–6/18), and severe visual impairment (6/60–3/60); 7.1% each. Ten patients (71.4%) required combination second-line immunomodulatory treatment during subsequent visits, and only four patients (28.6%) responded well to corticosteroid therapy. Most of the cases achieved no visual impairment (64.3%), followed by mild visual impairment (21.4%) and moderate visual impairment (14.3%), and none were severe or blind at the end of follow-up.
Conclusion: VKH is a potentially blinding illness if there is inadequate control of the disease in the acute stage. Most of our patients achieved good visual outcomes with early immunomodulatory treatment and systemic corticosteroids.
Keywords:
corticosteroid – Vogt-Koyanagi-Harada Disease – immunomodulatory – panuveitis
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