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

PURPOSE: To describe the clinical course and treatment outcomes of inflammatory choroidal neovascular membranes (CNVM) in patients with Vogt-Koyanagi-Harada (VKH) disease.

METHODS

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.

RESULTS

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).

CONCLUSION

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.