Analysis of 87 Cases with Vogt-Koyanagi-Harada Disease

Mondkar, Sandeep V.

doi:10.1016/s0021-5155(00)00152-0

Cited by 58 publications

(37 citation statements)

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“…Thus, it is critically important that the diagnosis of VKH be done accurately and as early as possible. 12,13 The Revised Diagnostic Criteria for VKH disease were discussed at the First International Workshop on VogtKoyanagi-Harada disease and reported from the consensus committee. According to the Revised Diagnostic Criteria, VKH disease can be divided into two subgroups, incomplete VKH and complete VKH disease.…”

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Application of revised diagnostic criteria for Vogt-Koyanagi-Harada disease in Japanese patients

2005

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Application of revised diagnostic criteria for Vogt-Koyanagi-Harada disease in Japanese patients

2005

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“…The diagnosis of VKH disease requires both ocular and extraocular symptoms and signs [Read et al, 2001]. However, only 20-40% of VKH patients develop neurological and auditory findings, such as meningismus and tinnitus, at the acute ophthalmic stage [Mondkar et al, 2000;Kitamura et al, 2005;Miyanaga et al, 2007]. The integumentary findings, such as alopecia, poliosis and vitiligo, usually appear in patients with VKH disease only in the convalescent stage, some 3-6 months after the onset of uveitis [Mondkar et al, 2000].…”

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confidence: 99%

“…However, only 20-40% of VKH patients develop neurological and auditory findings, such as meningismus and tinnitus, at the acute ophthalmic stage [Mondkar et al, 2000;Kitamura et al, 2005;Miyanaga et al, 2007]. The integumentary findings, such as alopecia, poliosis and vitiligo, usually appear in patients with VKH disease only in the convalescent stage, some 3-6 months after the onset of uveitis [Mondkar et al, 2000]. Therefore, with the present diagnostic criteria, accurate diagnosis of VKH disease in the acute ophthalmic stage is sometimes difficult, making physicians hesitant to begin high-dose systemic corticosteroid therapy.…”

Section: Discussionmentioning

confidence: 99%

“…Treatment of VKH disease is based on the early administration of high-dose systemic corticosteroids, followed by gradual tapering and maintenance for at least 6 months, and this regimen is associated with less intraocular inflammation, a decreased frequency of ocular recurrences and dermatologic features, and better visual outcomes [Rubsamen and Gass, 1991;Moorthy et al, 1995;Mondkar et al, 2000;Chee et al, 2009;Lai et al, 2009]. Clinicians should balance the benefits of uveitis control with the risk of side effects [Lai et al, 2009].…”

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confidence: 99%

“…Patients with VKH disease typically present with symptoms of aseptic meningitis initially followed by bilateral uveitis. Dermatologic changes occur several weeks or months after the onset of the ocular symptoms [Mondkar et al, 2000]. Otologic complaints may include sensorineural hearing loss, tinnitus and/or vertigo that typically coincide with the onset of ocular pathology [Kitamura et al, 2005;Ondrey et al, 2006].…”

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Characteristics and Prognosis of Hearing Loss Associated with Vogt-Koyanagi-Harada Disease

Morita

Nakamaru²,

Obara³

et al. 2013

Audiol Neurotol

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Objective: To clarify the characteristics and prognosis of hearing loss associated with Vogt-Koyanagi-Harada (VKH) disease. Methods: We retrospectively examined 85 patients diagnosed with VKH disease between January 1996 and December 2012. The control group included age- and gender-matched individuals without definitive ear disease. The patients with VKH disease were treated with high-dose systemic corticosteroids, which were tapered off gradually over a period of 6 months or more by the treating ophthalmologists according to the severity of the ocular inflammation. The features of hearing loss were analyzed based on pure tone audiometric data obtained at the initial presentation according to diagnostic criteria based on the ISO 7029 standard. The efficacy of corticosteroid therapy was evaluated by audiometry at the initial presentation and during therapy for 3-6 months. Results: In patients with VKH disease, the rate of hearing loss detected by audiometry was significantly higher than that of either subjective hearing loss (p < 0.001) or tinnitus (p < 0.001). Bilateral symmetrical hearing loss was the most common type of auditory disturbance associated with VKH disease. The degree of hearing loss was generally low, with no patients showing profound hearing loss. Hearing thresholds were significantly elevated at high frequencies compared with those at low-to-mid frequencies (p < 0.001). Hearing thresholds at all frequencies after high-dose corticosteroid therapy were significantly better than those at initial presentation (p < 0.001), and the rate of patients who returned to within normal-range pure tone thresholds at all frequencies was 74.8%. Conclusions: As auditory manifestations cannot be detected through history taking alone, audiometry should be performed to evaluate hearing loss associated with VKH disease. Early administration of high-dose systemic corticosteroids is effective for treating the auditory manifestations, which generally show a relatively good short-term prognosis.

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