The Relationship of Vogt-Koyanagi-Harada Syndrome to Ocular Hypertension and Glaucoma

Ocul Immunol Inflamm. 2017 Dec;25(6):748-752. doi: 10.1080/09273948.2016.1189578. Epub 2016 Jul 20.

Abstract

Purpose: Vogt-Koyanagi-Harada (VKH) syndrome is a systemic inflammatory autoimmune disease with associated ophthalmic pathology. Glaucoma has been reported in patients with VKH. The purpose of this report is to examine the frequency and types of glaucoma associated with VKH.

Methods: This was a retrospective case series. Electronic medical records of patients with VKH were reviewed from two medical centers: Duke University and the University of North Carolina.

Results: Of 45 eyes with VKH, 28 (62%) developed ocular hypertension (OHT) or glaucoma. In the patients with VKH and OHT/glaucoma, 18/28 (64%) had posterior synechiae and/or peripheral anterior synechiae.

Conclusions: We have shown a high prevalence of OHT and glaucoma in eyes with VKH. Furthermore, in addition to secondary open angle from corticosteroid treatment and uveitis, secondary angle closure resulting from posterior synechiae, frequently associated with iris bombé configuration, is an important cause of glaucoma in VKH eyes.

Keywords: Angle closure glaucoma; Vogt–Koyanagi–Harada; peripheral anterior synechiae; posterior synechiae; steroid induced glaucoma.

MeSH terms

  • Adult
  • Female
  • Glaucoma / diagnosis
  • Glaucoma / etiology*
  • Glaucoma / physiopathology
  • Glucocorticoids / therapeutic use
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Intraocular Pressure / physiology
  • Male
  • Middle Aged
  • Ocular Hypertension / diagnosis
  • Ocular Hypertension / etiology*
  • Ocular Hypertension / physiopathology
  • Retrospective Studies
  • Uveomeningoencephalitic Syndrome / complications*
  • Uveomeningoencephalitic Syndrome / diagnosis
  • Uveomeningoencephalitic Syndrome / drug therapy
  • Visual Acuity / physiology

Substances

  • Glucocorticoids
  • Immunosuppressive Agents