The coexistence of Vogt-Koyanagi-Harada and type I diabetes mellitus: a retrospective cohort study

To report the frequency, clinical characteristics, and management outcomes of patients who were diagnosed with Vogt-Koyanagi-Harada (VKH) disease and type 1 diabetes mellitus (T1DM). A retrospective cohort study that included all patients who were diagnosed with VKH disease and T1DM at King Khaled Eye Specialist Hospital and Research Center from 2014 to 2025. Among 621 patients with VKH, 13 patients (2.1%; 95% CI 1.1%–3.6%) were found to have VKH and T1DM, and a total of 26 eyes were included. The mean age at the onset of T1DM was 15.6 ± 5.7 years. The mean age at the onset of VKH was 26.4 ± 8.2 years. All patients presented with symptoms and signs of VKH disease. The type of VKH on presentation was initial-onset acute type in 4 patients (30.8%) and chronic recurrent type in 9 patients (69.2%). Non-proliferative diabetic retinopathy was developed in 6 eyes (23.1%), while 20 eyes did not show signs of diabetic retinopathy (76.9%). Six eyes (23.1%) developed diabetic macular edema. Glaucoma was recorded in 10 patients (20 eyes; 76.9%) and cataract in 7 patients (14 eyes; 53.8%). Mean logMAR BCVA (both eyes averaged per patient) improved from 1.05 (Snellen = 20/200) at presentation to 0.63 (Snellen = 20/80) at the last visit (mean improvement 0.42 logMAR; 95% CI 0.20 to 0.65; n = 13 patients). Although the onset of T1DM preceded VKH in this cohort, patients presented with symptoms and signs of VKH that required timely management. The development of ocular complications like cataract and glaucoma was commonly found in this subgroup of patients.