Incidence, Risk Factors and Surgical Outcomes of Cataract among Patients with Vogt-Koyanagi-Harada Disease

ABSTRACT

Purpose: To investigate risk factors and surgical outcomes of cataract in Vogt-Koyanagi-Harada (VKH) disease.

Methods: Review of 187 patients (374 eyes).

Results: At presentation, cataract was diagnosed in 56 (14.9%) eyes all had chronic recurrent VKH. During follow-up, cataract developed in additional 51 (13.6%) eyes. Fifteen (13.6%) of these had initial-onset acute VKH with anterior segment (AS) inflammation and 36 (19.4%) had chronic recurrent VKH. No patient with initial-onset acute VKH without AS inflammation developed cataract. Risk factors for cataract development during follow-up included female gender, keratic precipitates, anterior chamber reaction ≥2+, chronic recurrent VKH, posterior synechiae, iris nodules, glaucoma, glaucoma surgery, choroidal neovascular membrane, “sunset glow fundus” and chorioretinal atrophy. Thirty-two eyes underwent cataract extraction. Fourteen (43.8%) eyes achieved ≥20/40. Posterior segment complications of chronic recurrent VKH accounted for <20/40 outcome.

Conclusions: Poor outcome after surgery is secondary to posterior segment complications of chronic recurrent VKH.

Keywords:

• Cataract
• complications
• outcome
• uveitis
• Vogt-Koyanagi-Harada disease

Acknowledgments

The authors thank Ms. Connie B. Unisa-Marfil for secretarial assistance.

Declaration of interest

The authors declare no conflict of interest. The authors alone are responsible for the content and writing of the article.

Additional information

Funding

This work was supported by King Saud University through Vice Deanship of Research Chair, Dr. Nasser Al-Rashid Research Chair in Ophthalmology (Abu El-Asrar AM).