July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Identifying the Risk of Development of Macular Edema in Patients with Vogt-Koyanagi-Harada Disease
Author Affiliations & Notes
  • Maria Soledad Ormaechea
    Ophthalmology, Byers Eye Institute , Palo Alto, California, United States
    Ophthalmology, Hospital Universitario Austral, Pilar, Buenos Aires, Argentina
  • Muhammad Hassan
    Ophthalmology, Byers Eye Institute , Palo Alto, California, United States
  • Sarakshi Mahajan
    Ophthalmology, Byers Eye Institute , Palo Alto, California, United States
  • Anh NT Tran
    Ophthalmology, Byers Eye Institute , Palo Alto, California, United States
  • Muhammad Sohail Halim
    Ophthalmology, Byers Eye Institute , Palo Alto, California, United States
  • Günay Uludağ
    Ophthalmology, Byers Eye Institute , Palo Alto, California, United States
  • Jeong Hun Bae
    Ophthalmology, Byers Eye Institute , Palo Alto, California, United States
  • Khalid Yusuf Yaseen Al-Kirwi
    Ophthalmology, Byers Eye Institute , Palo Alto, California, United States
  • Rubbia Afridi
    Ophthalmology, Byers Eye Institute , Palo Alto, California, United States
  • Yasir Jamal Sepah
    Ophthalmology, Byers Eye Institute , Palo Alto, California, United States
  • Quan Dong Nguyen
    Ophthalmology, Byers Eye Institute , Palo Alto, California, United States
  • Ariel Schlaen
    Ophthalmology, Hospital Universitario Austral, Pilar, Buenos Aires, Argentina
  • Footnotes
    Commercial Relationships   Maria Ormaechea, None; Muhammad Hassan, None; Sarakshi Mahajan, None; Anh NT Tran, None; Muhammad Sohail Halim, None; Günay Uludağ, None; Jeong Hun Bae, None; Khalid Al-Kirwi, None; Rubbia Afridi, None; Yasir Jamal Sepah, None; Quan Nguyen, None; Ariel Schlaen, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 6665. doi:https://doi.org/
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      Maria Soledad Ormaechea, Muhammad Hassan, Sarakshi Mahajan, Anh NT Tran, Muhammad Sohail Halim, Günay Uludağ, Jeong Hun Bae, Khalid Yusuf Yaseen Al-Kirwi, Rubbia Afridi, Yasir Jamal Sepah, Quan Dong Nguyen, Ariel Schlaen; Identifying the Risk of Development of Macular Edema in Patients with Vogt-Koyanagi-Harada Disease. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6665. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To identify the incidence of macular edema after intraocular surgery in patients with Vogt-Koyanagi-Harada (VKH) disease

Methods : In this case control study, patients with diagnosis of VKH managed in the Department of Ophthalmology, Hospital Universitario Austral, Buenos Aires, Argentina between 2009 and 2017 were analyzed. The patients were divided into two groups based on the presence or absence of macular edema. Medical records were reviewed for the history of intraocular surgery. Patients were included in the study if they met the following criteria: 1) Confirmed diagnosis of VKH with and without the history of intraocular surgery; 2) Inactive VKH disease for at least three months prior to the intraocular surgery; 3) No complication associated with the surgery; 4) No history of any other ocular condition (i.e. diabetes, age-related macular degeneration) that may cause macular edema. All the patients received corticosteroids pre- and post-operatively. Age-matched analysis was performed utilizing logistic regression with propensity matching to compare the odds of a patient with VKH developing macular edema with a history of intraocular surgery to those with VKH developing macular edema without a history of intraocular surgery

Results : Forty-six (46) patients with a confirmed diagnosis of VKH disease were included in the study. Six patients (13.04%) had developed macular edema over the course of the disease, whereas 40 patients (86.96%) did not have a history of macular edema. Among the six patients with macular edema, five patients (83.33%) had a history of cataract surgery. Among the 40 patients without macular edema, four (10%) had undergone cataract surgery. None of the 46 patients underwent any other type of intraocular surgery. The odds of a patient with VKH developing macular edema after cataract surgery was 5 times compared to the odds of age-matched VKH patients developing macular edema without history of cataract surgery (p<0.0001)

Conclusions : Macular edema is a relatively rare finding in patients with VKH. However, cataract surgery significantly predisposes these patients for the development of macular edema, even with peri-operative anti-inflammatory treatment. Our findings highlight the role of other mechanisms beyond inflammation as the underlying cause of retinal edema in these patients

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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