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Outcomes of initial-onset acute uveitis associated with Vogt–Koyanagi–Harada disease occurred during pregnancy

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Abstract

Purpose

To investigate the outcomes of initial-onset acute uveitis associated with Vogt–Koyanagi–Harada (VKH) disease that occurred during pregnancy.

Methods

This is a retrospective case series.

Results

During the period between January 2001 and December 2021, we identified 112 patients with initial-onset acute uveitis associated with VKH disease, 67 (59.8%) were females. Among the female patients, 10 (14.9%) patients (20 eyes) were pregnant. Of these patients, 5 patients presented in the first trimester, 3 in the second trimester and 2 in the third trimester. The follow-up period ranged from 8 to 108 months (mean 35.2 ± 28.3 months). At presentation, 8 (80%) patients had initial-onset acute VKH disease with anterior segment (AS) inflammation and 2 (20%) initial-onset acute VKH disease without AS inflammation. All patients were initially treated with systemic corticosteroids combined with cyclosporine. During follow-up period, none of the patients with initial-onset acute VKH disease without AS inflammation developed any complications. Complications including "sunset glow fundus" in 8 (40%) eyes, cataract in 2 (10%) eyes and subretinal fibrosis in 1 (5%) eye were recorded in patients with initial-onset acute VKH disease with AS inflammation. Four (40%) patients developed pregnancy-related complications, including abortion in 1 patient, systemic hypertension in 1 patient and premature rupture of membrane in 2 patients. There were no documented congenital anomalies in all born babies. Best-corrected visual acuity of ≥ 20/20 was achieved in 16 (80%) eyes at the final follow-up.

Conclusion

Primary treatment with combined systemic corticosteroids and cyclosporine in initial-onset acute uveitis associated with VKH disease was safe and effective.

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Acknowledgements

The study is supported by King Saud University through Vice Deanship of Research Chair, Dr. Nasser Al Rashid Research Chair in Ophthalmology (Abu El-Asrar MA), Riyadh, Saudi Arabia.

Funding

The study is supported by King Saud University through Vice Deanship of Research Chair, Dr. Nasser Al Rashid Research Chair in Ophthalmology (Abu El-Asrar MA), Riyadh, Saudi Arabia.

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Authors and Affiliations

  1. Department of Ophthalmology, College of Medicine, King Saud University, Old Airport Road, P.O. Box 245, Riyadh, 11411, Saudi Arabia

    Arwa Z. Alromaih, Abdullah I. Almater, Abdulrahman F. Albloushi, Norah F. Alkheraiji & Ahmed M. Abu El-Asrar

  2. College of Medicine, Dr. Nasser Al-Rashid Research Chair in Ophthalmology, King Saud University, Riyadh, Saudi Arabia

    Ahmed M. Abu El-Asrar

Authors
  1. Arwa Z. Alromaih
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  2. Abdullah I. Almater
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  3. Abdulrahman F. Albloushi
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  4. Norah F. Alkheraiji
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  5. Ahmed M. Abu El-Asrar
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Contributions

AZA and AIA collected the data and wrote the manuscript. AFA, NFA and AMA interpreted and analyzed the data. All the authors critically edited the manuscript for intellectual content. All the authors read and approve the final manuscript.

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Correspondence to Ahmed M. Abu El-Asrar.

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This study was performed in line with the principles of the Declaration of Helsinki and has been evaluated by the Institutional Review Board at King Abdulaziz University Hospital and deemed not to require ethics approval.

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Informed consent was obtained from all individual participants included in the study.

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Alromaih, A.Z., Almater, A.I., Albloushi, A.F. et al. Outcomes of initial-onset acute uveitis associated with Vogt–Koyanagi–Harada disease occurred during pregnancy. Int Ophthalmol 43, 185–195 (2023). https://doi.org/10.1007/s10792-022-02415-1

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