Clinical characteristics of Vogt–Koyanagi–Harada syndrome in a tertiary medical centre in western region of Kingdom of Saudi Arabia

ObjectiveTo characterize the clinical features of Vogt–Koyanagi–Harada (VKH) syndrome in a tertiary medical centre in western region of Kingdom of Saudi Arabia.MethodRetrospective review of the records of patients who presented to the uveitis clinic between December 2001 and 2011.ResultsWe found 48 patients of VKH, and enrolled 32 patients who had completed at least 6 months of follow up. The mean duration of follow up was 17.34 ± 13.45 months (range 6–60 months); 65.6% were female and 34.4% were male; and the mean age at disease onset was 33 ± 10.8 years (range 15–58 years). The majority (56.2%) had incomplete disease while 28.1% had complete disease and 15.6% probable disease. Extra ocular symptoms were common. We categorized the patients by presentation patterns. Those in the acute stage presented with panuveitis and bullous retinal detachment, while most of those in the convalescent stage presented with sunset glow fundus and nummular choreo-retinal scars. Auditory manifestations were seen in patients with chronic and recurrent stage, and cutaneous manifestations were seen in 53% of all patients. Cataract (53%) and glaucoma (9.3%) were the main complications. Acute-stage patients were treated with systemic steroids and those with chronic and recurrent disease with immunosuppressives. Over all, the visual prognosis was good, 62.5% of patients maintaining 20/40 or better visual acuity.ConclusionVKH is a common cause of uveitis in Kingdom of Saudi Arabia, often with extra-ocular symptoms. Patients can maintain good visual acuity when treated aggressively with systemic steroids in acute stage and immunosuppressive agents in chronic and recurrent stages.