Incidence of Cataract Surgery and Visual Acuity Outcomes in Patients with Vogt-Koyanagi-Harada Disease
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Purpose
To assess the incidence, predictive factors for cataract surgery, and postoperative visual acuity (VA) outcomes in patients with Vogt-Koyanagi-Harada disease (VKH).
Methods
A retrospective chart review of patients diagnosed with VKH between 2010 and 2023 were performed. The Kaplan-Meier curve was constructed for time to cataract surgery. The longitudinal pattern of mean postoperative VA was analyzed using a linear mixed model. Factors associated with postoperative VA of 20/40 or greater at 6 months were identified using logistic regression analyses.
Results
197 phakic eyes of 100 patients were included. Over a median follow-up of 3.3 years (IQR,1.7-6.5), cataract surgery was performed in 41 eyes (24 patients) (incident rate=5.4/100 eye-years). The cumulative incidences of cataract surgery were 21.7% and 27.9% at 3 and 5 years after disease onset, respectively. Age at onset of VKH >46 years (adjusted hazard ratio [aHR]= 7.9, P=0.002], female (aHR= 5.1, P=0.002), prednisolone dose at presentation > 40 mg/day (aHR=2.7, P=0.031), use of antiglaucoma medication prior to surgery (aHR= 5.6, P=0.017), and history of receiving regional corticosteroid injection prior to surgery (aHR=12.9, P=0.001) were predictive of undergoing cataract surgery. The mean VA improved from 1.2 logMAR at preoperative to 0.3 logMAR at 6-month. Receiving non-steroidal immunomodulatory therapy (adjusted odds ratio [aOR]=14.2, P=0.034) and absence history of regional corticosteroid injection prior to surgery (aOR=19.3, P=0.009) increased the likelihood of achieving postoperative VA of 20/40 or greater.
Conclusion
There was a moderate risk of cataract surgery in patients with VKH. Postoperative visual outcome was mostly favorable.
Conflict of interest
No
1
Last name
SITTIVARAKUL
Initials of first name(s)
W
Department
Department of Ophthalmology, Faculty of Medicine, Prince of Songkla University
City
Songkla
Country
Thailand
2
Last name
CHANTINMATHORN
Initials of first name(s)
K
Department
Department of Ophthalmology, Faculty of Medicine, Prince of Songkla University
City
Songkla
Country
Thailand
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