Clinical characteristics and long-term outcomes of Vogt-Koyanagi-Harada disease in pediatric age group.

Purpose: The purpose of this retrospective study is to evaluate the clinical presentations and long-term outcomes of uveitis secondary to Vogt-Koyanagi-Harada (VKH) disease in children.

Methods: Five pediatric patients diagnosed with VKH disease were analyzed with respect to their clinical characteristics, presenting signs and symptoms, complications, and long-term outcomes. The median follow-up duration was 8 years, providing rare longitudinal data in the pediatric VKH population.

Results: Ocular findings at presentation included anterior chamber cells (6 eyes, 60%), keratic precipitates (3 eyes, 30%), posterior synechiae (4 eyes, 40%), depigmented scars (4 eyes, 40%), disc edema (1 eye, 10%), exudative retinal detachment (2 eyes, 20%) and 'sunset-glow' fundus (4 eyes, 40%). The mean best corrected visual acuity improved from 20/32 to 20/25 at last follow-up. Complications were observed in several cases, including cataracts (40%), glaucoma (20%), and choroidal neovascularization (30%). Systemic corticosteroids and immunosuppressants were used in all patients, with varied treatment responses and recurrence rates. Two patients required surgical intervention for cataracts and glaucoma.

Conclusion: Pediatric VKH patients are prone to significant complications such as cataracts, glaucoma, and choroidal neovascularization. Despite these complications, appropriate use of systemic corticosteroids and immunosuppressants can lead to favorable visual outcomes. Long-term careful monitoring is essential to manage recurrences, complications and prevent vision-threatening complications.