Case report shows successful inflammation control in a pregnant woman with VKH, suggesting alternative therapy routes. Dexamethasone may offer a safer option than traditional corticosteroids.
Vogt–Koyanagi–Harada (VKH) disease is a systemic autoimmune disease typically managed with high-dose corticosteroids (>10 mg/day), which may pose a risk to maternal and fetal health if administered during pregnancy. We report a first-ever case of bilateral VKH disease in early pregnancy, who was successfully treated with an intravitreal dexamethasone implant in both eyes. There was rapid control of inflammation without maternal or fetal complications, and the patient delivered a healthy infant at term, free of congenital anomalies. This case highlights the potential of intravitreal dexamethasone as a safe and effective stop-gap measure, alternative to systemic corticosteroids. Treatment of VKH in pregnancy should be tailored to each patient depending on the gestational age of the patient and severity of inflammation, balancing disease control with maternal and foetal safety.
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Makam et al. (2025) studied this question.
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