Prevalence, Clinical Course, and Treatment Outcomes of Inflammatory Choroidal Neovascular Membranes in Vogt-Koyanagi-Harada disease.

Abstract

To describe the clinical course and treatment outcomes of inflammatory choroidal neovascular membranes (CNVM) in patients with Vogt-Koyanagi-Harada (VKH) disease. This is a retrospective chart review which included all VKH patients who were diagnosed with inflammatory CNVM at King Khaled Eye Specialist Hospital (KKESH) between the years 2014 and 2025. Fifty-seven eyes of 37 VKH patients were diagnosed with CNVM. The mean age of the patients at presentation was 35.3 ± 14.6 years. The type of VKH was chronic recurrent in 25 patients (67.6%), while it was initial-onset acute in 12 patients (32.4%). In 42 eyes (73.7%), the CNVM was present at presentation, while 15 eyes (26.3%) developed CNVM after an average of 37.3 ± 29.4 months. The CNVM was bilateral in 20 patients (54.1%) while 17 patients (45.9%) had unilateral disease. Treatments were given to 49 eyes (85.9%), where anti-VEGF was given to 47 (82.5%) and photodynamic therapy to 2 (3.5%). Multiple anti-VEGF agents were used in 20 eyes (41.7%). The mean number of CNVM reactivations was 3.98 ± 3.9 times in 43 eyes (75.4%). The mean number of injections was 8.4 ± 10.6 injections. There was an overall significant improvement in BCVA at the last follow-up visit (p=0.008). The reduction in central retinal thickness was statistically significant (p<0.001). Inflammatory CNVM is an infrequent complication in patients with VKH. Good visual and anatomical improvements can be achieved with appropriate control of systemic inflammation and timely management of the CNVM.