Predictive factors for risk of chronic evolution in Vogt–Koyanagi–Harada disease at 1 month after pulse steroid therapy

In this study, we aimed to identify factors for risk of chronic evolution in Vogt–Koyanagi–Harada (VKH) disease at 1 month following pulse steroid therapy. This was a retrospective clinical cohort, single center study. A total of 121 eyes from 61 treatment-naïve patients with acute VKH disease, who underwent pulse steroid therapy and had follow-up for over 12 months were evaluated. Patients were categorized into SGF and non-SGF groups according to fundus outcomes at 12 months after treatment. Anterior chamber morphology was assessed using Pentacam ® , while axial length and lens thickness were measured with the IOLMaster 700. Multivariable analysis demonstrated that lower best-corrected visual acuity (BCVA) ( p < 0.001) and increased corneal thickness ( p = 0.016) at 1 month were significantly associated with the development of SGF. Receiver operating characteristic curve analysis determined optimal cut-off values for predicting SGF as a logarithmic BCVA greater than −0.040 and a corneal thickness exceeding 574.500 µm. The corresponding Youden index values were 0.291 for BCVA and 0.244 for corneal thickness. Elevated logarithmic BCVA values and increased corneal thickness at 1 month after treatment were identified as risk factors for the subsequent SGF development. Applying higher cut-off values for these factors may facilitate more targeted therapeutic strategies in patients with VKH disease.