Vogt−Koyanagi−Harada disease

Burkholder, Bryn M.

doi:10.1097/icu.0000000000000206

Cited by 41 publications

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“…Enhanced depth imaging (EDI) OCT reveals a thickened choroid and can be used to monitor serous retinal detachments. Hypofluorescent pinpoint dots at the early phase of FA followed by multiple focal areas of leakage and subretinal dye accumulation at the late phase can be seen [15–17]. In chronic VKH, peripheral FAF abnormalities are seen.…”

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confidence: 99%

Multi-modal imaging and anatomic classification of the white dot syndromes

et al. 2017

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The white dot syndromes (WDS) are a diverse group of posterior uveitidies that share similar clinical findings but are unique from one another. Multimodal imaging has allowed us to better understand the morphology, the activity and age of lesions, and whether there is CNV associated with these different ocular pathologies. The “white dot syndromes” and their uveitic masqueraders can now be anatomically categorized based on lesion localization. The categories include local uveitic syndromes with choroidal pathology, systemic uveitic syndromes with choroidal pathology, and multifocal choroiditis with outer retinal/choriocapillaris pathology with uveitis and without uveitis. Neoplastic and infectious etiologies are also discussed given their ability to masquerade as WDS.

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Section: Main Textmentioning

confidence: 99%

Multi-modal imaging and anatomic classification of the white dot syndromes

et al. 2017

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“…Vogt–Koyanagi–Harada (VKH) is a multisystem autoimmune inflammatory disorder with ophthalmic, auditory, dermatologic, and neurologic manifestations. 1 The prevalence of this disease varies with ethnicity. VKH characteristically affects pigmented groups, such as Hispanics, Asians, people from the Middle East, and Asian Indians, but not the blacks of sub-Saharan African descent.…”

Section: Introductionmentioning

confidence: 99%

Clinical spectrum and management options in Vogt–Koyanagi–Harada disease

Lodhi

Reddy

Peram

2017

OPTH

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PurposeThe aim of this study was to describe the clinical features, treatment options, and visual outcome of Vogt–Koyanagi–Harada (VKH) disease patients over a 9-year period.MethodA retrospective chart analysis of 32 patients with VKH, from January 2007 to December 2015, at a tertiary care government medical college eye hospital in South India.ResultsA total of 32 patients were diagnosed with VKH. The mean age at diagnosis was 32.03±8.8 years. There were 24 patients (42 eyes) with acute VKH and eight patients (16 eyes) with recurrent/chronic VKH. The mean baseline best-corrected visual acuity on presentation in the acute VKH group was 5/60 (1.114±0.565) and at last follow-up it was 6/9 (0.225±0.157). Intravenous methyl prednisolone (IVMP) was administered for 3 days to all patients with acute and recurrent VKH, followed by posterior subtenon triamcinolone (40 mg/mL) and oral azathioprine.ConclusionVKH-related uveitis is more common in the female gender in this South Indian population. Posterior uveitis is the most common initial manifestation. Initial aggressive treatment with IVMP, peribulbar long-acting corticosteroids, and immunosuppressives, avoiding side effects of systemic steroids, gives a good visual outcome without recurrences. Cases of unilateral VKH, seen in six patients, are the initial manifestations in the natural course of the disease, which if managed aggressively at the acute stage prevents recurrence in the other eye.

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“…HLA-DRB1*0405). [1,2] VKHS is responsible for only a small percentage of uveitis (1%-8% depending on the series [3] ). It is more common in women, with a female/male ratio of 2 to 1, and usually occurs between the age of 20 and 50 years, with a peak in the third decade.…”

Section: Introductionmentioning

confidence: 99%

“…The presence of extra-ocular symptoms varies in different ethnic groups. [2][3][4] The classic clinical course of VKHS can be divided into 4 clinical stages. [3] The prodromal phase is short (days) and resembles a viral infection, with non-specific symptoms as fever, nausea, headache and photophobia, and is associated with a lymphocytic pleocytosis of the cerebrospinal fluid (CSF).…”

Section: Introductionmentioning

confidence: 99%

“…methotrexate, azathioprine, cyclosporine, rituximab, adalimumab) is given in case of corticosteroid resistance or side effects. [1][2][3][4][10][11][12][13][14][15] Ocular complications linked to both disease activity and treatment may lead to permanent visual loss after extinction of the uveitic phase. [3,10] The visual prognosis of VKHS varies and depends mainly on early diagnosis and rapid appropriate treatment.…”

Section: Introductionmentioning

confidence: 99%

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Vogt-Koyanagi-Harada syndrome: Experience in a Belgian university hospital and review of the literature

Sels

Calster

Vanderschueren

et al. 2017

CRIM

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Introduction: The Vogt-Koyanagi-Harada syndrome (VKHS) is rare in Europe. Bilateral panuveitis is the defining characteristic, but the disease can affect other tissues containing melanin, such as the inner ear, the meninges, and the skin. Therefore, patients may present not only to ophthalmologists, but also to internists, dermatologists, ENT-physicians and neurologists. Early and aggressive immunosuppressive treatment is necessary in order to prevent permanent visual loss or systemic complications. Objective: We retrospectively studied 12 patients diagnosed and treated in a specialized uveitis clinic in Leuven (Belgium) between 2005 and 2013, and we compared our data with literature. Results:The most common extra-ocular manifestations were neurological, with headache (100%) and lymphocytic meningitis (75%) as main findings. Tinnitus was present in 50%, and vertigo in 42%. Vitiligo was the most frequent dermatological manifestation and present in 42%. Uveitis recurred in 67% of patients with 1 to 4 relapses per patient and a median time to recurrence of 6 months (range 1-11). Normal visual acuity was seen in 75% of patients at the end of follow-up (5 to 60 months), but 3 patients had at least some degree of permanent visual impairment in at least one eye. Conclusion: VKHS is a rare, multisystem disorder, characterized by bilateral uveitis and variable neurologic, auditory and skin symptoms. A lumbar puncture increases the diagnostic yield. A fast diagnosis allows timely initiation of adequate therapy, and If treated correctly, VKHS has a favorable prognosis. It is unclear if initial intravenous therapy improves frequency and time to remission.

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Vogt−Koyanagi−Harada disease

Abstract: VKH disease is an autoimmune, multisystem inflammatory disorder, the cause of which is still incompletely understood. Continued research may elucidate the causes and triggers of immune dysregulation in this disease, and in doing so, identify novel therapeutic targets.

Cited by 41 publications

References 41 publications

Multi-modal imaging and anatomic classification of the white dot syndromes

Multi-modal imaging and anatomic classification of the white dot syndromes

Clinical spectrum and management options in Vogt–Koyanagi–Harada disease

Vogt-Koyanagi-Harada syndrome: Experience in a Belgian university hospital and review of the literature

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Vogt−Koyanagi−Harada disease

Abstract: VKH disease is an autoimmune, multisystem inflammatory disorder, the cause of which is still incompletely understood. Continued research may elucidate the causes and triggers of immune dysregulation in this disease, and in doing so, identify novel therapeutic targets.

Cited by 41 publications

References 41 publications

Multi-modal imaging and anatomic classification of the white dot syndromes

Multi-modal imaging and anatomic classification of the white dot syndromes

Clinical spectrum and management options in Vogt&ndash;Koyanagi&ndash;Harada disease

Vogt-Koyanagi-Harada syndrome: Experience in a Belgian university hospital and review of the literature

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Clinical spectrum and management options in Vogt–Koyanagi–Harada disease