Vogt-Koyanagi-Harada Syndrome in a Canadian First Nations Population. (19th May 2022)

• Record Type: Journal Article
• Authors: Kryshtalskyj, Michael T.; Roy, Mili
• Is Part Of: Ocular immunology and inflammation. Volume 30:Number 4(2022)
• Page Start: 894
• Page End: 900
• Publication Date: 2022-05-19
• Subjects: Uveitis -- Vogt-Koyanagi-Harada -- VKH -- First Nations -- Aboriginal -- Indigenous -- Canada -- rural -- immunomodulatory therapy -- immunosuppression; Eye -- Diseases -- Immunological aspects -- Periodicals; Eye -- Inflammation -- Periodicals; 617.7
• DOI: 10.1080/09273948.2020.1849737
• Languages: English
• ISSNs: 0927-3948

Abstract

ABSTRACT: Purpose: To characterize presentations, characteristics and outcomes of uveitis in Vogt-Koyanagi-Harada (VKH) syndrome in a North American First Nations (FN) population. Methods: Charts of 27 Canadian FN patients with VKH uveitis were retrospectively reviewed to characterize demographics, disease characteristics, management, complications and visual outcomes. Results: Average age at uveitis onset was 30.9 ± 13.8 years. Twenty-six patients 10 (96.3%) were female. Nine patients (33.3%) demonstrated complete VKH, 8 (29.6%) incomplete, and 10 (37%) probable VKH. Systemic associations included integumentary (19 patients, 70%), neurologic (17 patients, 63%), and auditory (13 patients, 48%) findings. Initial rates of mild, moderate and severe vision loss were 19 eyes (35.2%), 12 eyes (22.2%), and 23 eyes (42.6%), respectively, compared with final rates of 19 eyes (35.2%), 14 eyes (25.6%) and 21 eyes (38.9%), respectively. Average change in visual acuity was 15 0.1 ± 6.3 Snellen lines. Rates of immunomodulatory therapy (IMT) use (10 patients, 37%) fell short of targets. Conclusions: VKH may cause potentially severe uveitis in this population. Comorbidities including tuberculosis and diabetes, in addition to unique cultural, linguistic and geographic factors, may necessitate complex, individualized management strategies.