Sunset glow fundus in Vogt-Koyanagi-Harada disease with or without chronic ocular inflammation

Background: Sunset glow fundus is considered an important ocular finding for diagnosing and understanding the pathogenesis of Vogt-Koyanagi-Harada (VKH) disease. In this study, we investigated the association between the incidence of chronic ocular inflammation in VKH disease and the appearance of sunset glow fundus. Methods: The study was a retrospective noncomparative interventional case series. Eighty patients with VKH disease treated with high-dose corticosteroid therapy from initial onset were included in the study. We compared the incidence of sunset glow fundus between patients with VKH disease with chronic ocular inflammation lasting more than 6 months and those without chronic ocular inflammation. Results: Chronic ocular inflammation was seen in 14 of 80 patients (17.5%). The presence of severe anterior uveitis were significantly more frequent in the chronic group. Forty-one patients (62%) without chronic ocular inflammation showed sunset glow fundus, while 13 patients (93%) with chronic ocular inflammation developed sunset glow fundus. Duration from disease onset to appearance of sunset glow fundus was significantly shorter in patients with than in patients without chronic inflammation. Conclusions: There is a significant association between the incidence of chronic ocular inflammation lasting more than 6 months and the appearance of sunset glow fundus. In addition, more severe disease at onset might be associated with chronic ocular inflammation in VKH disease.