Alterations of color vision and central visual field in patients with Vogt−Koyanagi−Harada syndrome

PURPOSE To investigate the changes of color vision and central visual field in a cohort of patients with Vogt-Koyanagi-Harada (VKH) syndrome. METHODS Sixteen VKH patients (32 eyes) were enrolled in this study. All the patients were treated with immunosuppressive agents. The best visual acuity, visual field testing and color vision testing were available from the records in all these patients at different time points, i.e. before treatment and 1 month (±7 days), 3 months (±15 days), 6 months (±20 days) and 12 months (±30 days) after treatment. RESULTS All patients showed active intraocular inflammation at their first visit. A decreased visual acuity, abnormality of color vision and abnormal visual field were observed at presentation. Visual acuity and color vision rapidly improved at 1 and 3 months and gradually improved thereafter. Visual field defects significantly improved at 6 months and gradually improved thereafter. However, visual field defects were still observed in 27.5% of the tested patients following a 12-month treatment. Color vision returned to the normal level only in about one-third of these patients at this time point. CONCLUSIONS Visual function was severely impaired in VKH patients with active uveitis but rapidly improved following immunosuppressive therapy. Visual fields are much more severely affected by the disease than visual acuity and its improvement lagged behind that of visual acuity and color vision.