Long-term visual and clinical outcomes in Vogt Koyanagi Harada disease – Insights from 395 eyes in a referral eye centre in Eastern India

Purpose To evaluate long-term complications in Vogt–Koyanagi–Harada (VKH) disease, assess disease progression, and measure its impact on visual acuity during follow-up at a tertiary eye-care center in Eastern India. Methods This retrospective cross-sectional observational study reviewed VKH cases diagnosed between 2005 and 2023 using electronic medical records from a tertiary eye-care center in Eastern India. Clinical data points were collected, compiled, and analyzed. Findings were compared with similar studies. Results A total of 395 eyes from 207 patients were analyzed. Of these, 188 patients (90.82%) had bilateral involvement and 19 (9.18%) had unilateral involvement. Patients presented in various stages of the disease. The most common complication was complicated cataract (133 eyes, 33.67%), followed by glaucoma (123 eyes, 31.14%) and sunset glow fundus (95 eyes, 16.45%). Vision improved in 141 eyes (35.70%), deteriorated in 145 eyes (36.71%), and remained stable in 107 eyes. Conclusion VKH patients in Eastern India showed rare systemic features. Topical steroids, intravenous methylprednisolone, and oral steroids with immunosuppressive therapy were effective first-line treatments for preserving vision. However, one-third of eyes showed long-term visual deterioration. Cataract and glaucoma were the most common complications. Swept-source optical coherence tomography aided diagnosis and follow-up.