Clinical Characteristics, Recurrences, and Complications in the Mexican Pediatric Patients with Vogt-Koyanagi-Harada Disease.

Abstract

Purpose: To analyze the clinical characteristics, number of recurrences, and complications in the Mexican pediatric patients with Vogt-Koyanagi-Harada (VKH) disease.

Methods: A retrospective review of pediatric patients aged 16 years and under, diagnosed with VKH, was conducted from January 1988 to February 2023 at Asociación para Evitar la Ceguera en México I.A.P.

Results: Thirty-one patients (n = 62 eyes), with a diagnosis of VKH were identified, with a mean age of 12.06   ±   3.57 years. Follow-up was 7.22   ±   6.85 years. At initial presentation, the best-corrected visual acuity (BCVA) was 1.31   ±   0.94 LogMAR (Snellen 20/400) and final 0.5   ±   0.93 LogMAR (Snellen 20/60) (p = 0.001). The most common clinical findings in the uveitic stage were anterior chamber inflammation (70%) and serous retinal detachment (72%). The treatment approach involved a combination of oral steroids, intravenous steroids, and immunomodulatory agents. Despite the initial visual impairment, most patients achieved disease remission. However, 41.93% of the patients experienced at least one recurrence during follow-up. The most frequent complications were sunset-glow fundus 74.19% (n = 46 eyes), and glaucoma 27.41% (n = 17 eyes).

Conclusion: VKH disease in the Mexican pediatric patients has proved to be a challenge in management due to its aggressive course. Timely diagnosis and treatment with steroid therapy associated with a systemic immunomodulatory are essential to reduce recurrences, and complications and thus have a better visual prognosis.