Long-term Recovery of Retinal Structure and Function in Vogt-Koyanagi-Harada Disease: A 5-Year Follow-up Study Using Adaptive Optics Imaging and Fundus Microperimetry

Vogt-Koyanagi-Harada (VKH) disease recovery patterns remain inadequately characterized over extended periods. This study evaluated retinal changes in VKH patients across 5 years using adaptive optics imaging and microperimetry. Twenty-five eyes from 13 patients were monitored longitudinally. Macular cone density gradually increased throughout the observation period but remained below healthy control levels. Eyes with pretreatment cystoid spaces initially showed lower cone density values, but this disparity disappeared after 3 years. Average threshold values improved consistently from baseline, while macular integrity values significantly decreased after 2 years. Cone density correlated significantly with retinal sensitivity. These findings indicate that with appropriate treatment, VKH disease demonstrates progressive improvement in both retinal structure and function over time, though complete structural recovery may not occur. Pretreatment cystoid spaces influence early outcomes but do not significantly affect long-term recovery.