Introduction Vogt-Koyanagi-Harada disease is an inflammatory condition marked by bilateral granulomatous panuveitis and multiple extraocular signs and symptoms. The exact etiology is unknown, but current theories suggest that it is a T cell–mediated autoimmune disorder affecting melanocytes. Hormonal changes during and after pregnancy have been shown to trigger activation or exacerbation of autoimmune diseases, such as Vogt-Koyanagi-Harada disease. Case Report A 36-year-old Hispanic woman presented with headache, bilateral ocular pain, and progressively worsening vision. Her medical history was positive for an uncomplicated labor and delivery 3 months prior, and she was actively breastfeeding. Ocular examination revealed bilateral panuveitis with multiple serous retinal detachments in both eyes. The findings were consistent with Vogt-Koyanagi-Harada disease. Systemic and topical corticosteroid along with topical cycloplegic therapy were initiated. Signs and symptoms gradually improved; however, abrupt prednisone discontinuation after 3 months led to a worsening of the condition, which highlights the importance of long-term treatment in patients with Vogt-Koyanagi-Harada disease. Conclusion Vogt-Koyanagi-Harada disease is one of several autoimmune conditions that can be influenced by the postpartum period. It should be considered as part of the differential diagnosis in postpartum women presenting with bilateral granulomatous anterior uveitis or panuveitis, particularly when accompanied by serous retinal detachment. Changes in estrogen, progesterone, and prolactin hormone levels along with endogenous corticosteroid production before and after pregnancy may lead to an increase in noninfectious uveitic disease activity in postpartum females. Because pregnancy and the postpartum period can influence the clinical course of autoimmune conditions, additional studies are needed to refine diagnostic and therapeutic strategies for these patients.
Ansari et al. (Fri,) studied this question.