Ocular Hypertension and Glaucoma in Vogt Koyanagi Harada Syndrome

Background: Vogt-Koyanagi-Harada syndrome is a multisystem disease of autoimmune etiology, affecting melanocyte-containing tissue such as the uvea, ear, skin, and meninges.Objective: is to determine the incidence of glaucoma and ocular hypertension in patients with Vogt-Koyanagi-Harada syndrome at a referral center in Iraq.Methods: A prospective case series study, included patients diagnosed with Vogt Koyanagi Harada syndrome which was performed at the uveitis clinic in Ibn AL-Haitham teaching eye Hospital in Baghdad, Iraq from April 2021 to February 2022 (10 months). Detailed general and ophthalmic history was obtained and detailed ocular examination including best corrected visual acuity, intraocular pressure, and slit lamp examination as well as gonioscopy using three mirror lens were performed on the patients.Results: Among 68 eyes of 36 patients with VKH, 44 eyes (64.7%) of 23 patients developed IOP elevation, Of these, 21 eyes (30.9%) of 11 patients had ocular hypertension and 23 eyes (33.8%) of 12 patients had glaucoma. The mechanisms of glaucoma were open angle in 20 eyes (87%) and angle closure in 3 eyes (13%). 18 eyes(78.3%) with glaucoma required surgical intervention consisting of trabeculectomy with Mitomycin C or Ahmed glaucoma valve, the latter was the procedure of choice which was done for 13 eyes(56.5%).Conclusion: According to this study the incidence of ocular hypertension was 30.9%, while the incidence of glaucoma was 33.8% in eyes with VKH disease. Open angle glaucoma according to gonioscopic finding was the most common mechanism of IOP elevation.