INCIDENCE AND MANAGEMENT OF GLAUCOMA IN VOGT-KOYANAGI-HARADA SYNDROME

Background: The Vogt-Koyanagi-Harada syndrome is a bilateral panuveiti s associated with neurologic and dermatologic manifestations. Methods: The authors reviewed the charts of all patients with Vogt-Koyanagi-Ha rada syndrome seen at their institution over the past decade to determ ine the incidence of glaucoma, as well as the results of medical and s urgical therapy for glaucoma, in this group of patients. Findings: Of 42 patients diagnosed with Vogt-Koyanagi-Harada syndrome, evidence of glaucoma requiring either medical or surgical intervention occurred in 16 patients (38.1%). Of these, nine (56.3%) had open-angle glaucoma a nd seven (43.7%) had angle-closure secondary to pupillary block. In 5 (31.3%) of the 16 patients, medical therapy alone was sufficient to co ntrol intraocular pressure. Eleven patients (68.7%) required surgical intervention, consisting of laser iridotomy, surgical iridectomy, trab eculectomy with or without 5-fluorouracil, and/or Molteno implantation . Conclusion: The relative success of each of these procedures in this group of patients is discussed. Glaucoma is a common complication in the Vogt-Koyanagi-Harada syndrome, and one that is often difficult to control.