Vogt-Koyanagi-Harada disease

Joye, Ashlin; Suhler, Eric B.

doi:10.1097/icu.0000000000000809

Cited by 22 publications

(19 citation statements)

References 62 publications

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“…BRAF/MEK inhibitors interfere with the MAPK pathway, which is involved in the T-cell receptor signaling pathway[ 17 ]. This interference could lead to similar changes in the choroid and RPE as observed in VKH disease[ 15 ].…”

Section: Discussionmentioning

confidence: 99%

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Choroidal thickening with serous retinal detachment in BRAF/MEK inhibitor-induced uveitis: A case report

Kiraly¹,

Groznik²,

Valentinčič³

et al. 2022

WJCC

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BACKGROUND Immune checkpoint inhibitors have revolutionized the treatment of patients with unresectable metastatic malignant melanoma. In addition to systemic side effects, several usually mild ocular adverse effects have been reported. We report a case of rarely reported vision-threatening bilateral panuveitis with serous retinal detachment, thickened choroid, and chorioretinal folds associated with dabrafenib and trametinib targeted therapy for B-Raf proto-oncogene serine/threonine kinase (BRAF) mutant metastatic cutaneous melanoma. CASE SUMMARY A 59-year-old female patient with metastatic melanoma treated with dabrafenib and trametinib presented with blurry vision and central scotoma lasting for 3 d in both eyes. Clinical examination and multimodal imaging revealed inflammatory cells in the anterior chamber, mild vitritis, bullous multiple serous retinal detachments, and chorioretinal folds in both eyes. Treatment with dabrafenib and trametinib was suspended, and the patient was treated with topical and intravenous corticosteroids followed by oral corticosteroid treatment with a tapering schedule. One and a half months after the disease onset, ocular morphological and functional improvement was noted. Due to the metastatic melanoma dissemination, BRAF/mitogen-activated protein kinase inhibitors were reintroduced and some mild ocular adverse effects reappeared, which later subsided after receiving oral corticosteroids. CONCLUSION Patients on combination therapy with dabrafenib and trametinib may rarely develop severe bilateral panuveitis with a good prognosis. Further studies have to establish potential usefulness of ophthalmological examination for asymptomatic patients. Furthermore, appropriate guidelines for managing panuveitis associated with dabrafenib and trametinib should be established.

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Section: Discussionmentioning

confidence: 99%

“…The mechanism behind BRAF/MEK inhibitor induced panuveitis, which clinically closely resembles the Vogt-Koyanagi-Harada (VKH) disease[ 15 ], remains unclear. In the VKH disease pathogenesis, CD4+ and CD8+ cells (T cells) target melanocytic antigens in the choroid and RPE, which impair the outer blood retinal barrier[ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Choroidal thickening with serous retinal detachment in BRAF/MEK inhibitor-induced uveitis: A case report

Kiraly¹,

Groznik²,

Valentinčič³

et al. 2022

WJCC

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“…VKH disease is an autoimmune disease that primarily targets melanocytes and is characterized by bilateral granulomatous panuveitis with neurosensory symptoms such as impaired hearing, tinnitus, and vitiligo [ 1 , 12 ]. Owing to the abundance of melanocytes in choroidal tissue, T cells mediate an autoimmune response of melanocytes that leads to choroidal matrix inflammation and a series of ocular manifestations due to the involvement of the retinal pigment epithelium and retina.…”

Section: Discussionmentioning

confidence: 99%

“…Vogt-Koyanagi-Harada (VKH) disease is an autoimmune disease that afects multiple systems, including eyes, skin, inner ear, and meninges. It is common in China and its etiology is unknown [1]. Although the most common ocular feature of VKH disease is serous retinal detachment [2], 14.6%-27.6% of patients in prior reports presented with more signifcant optic disc swelling without serous retinal detachment [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Changes of Peripapillary Capillary Density in Patients with Vogt–Koyanagi–Harada Disease Evaluated by Optical Coherence Tomography Angiography

Jiang

Zhang

et al. 2023

Journal of Ophthalmology

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Objective. To analyze the longitudinal changes in peripapillary capillary density in patients with acute VKH with or without optic disc swelling by optical coherence tomography angiography (OCTA). Methods. Retrospective case series. 44 patients (88 eyes) were enrolled and were divided into two groups according to presence/absence of optic disc swelling before treatment. Peripapillary capillary images were obtained by OCTA before and after 6 months of corticosteroid treatment and used to determine the radial peripapillary capillary (RPC), retinal plexus, and choriocapillaris vessel perfusion densities. Results. Optic disc swelling was present in 12 patients (24 eyes) and absent in 32 patients (64 eyes). The sex distribution, age, intraocular pressure, and best-corrected visual acuity before and after treatment were not significantly different between the two groups (all P > 0.05 ). Compared to those in nonoptic disc swelling group, the percentages of decreased vessel perfusion densities after treatment in the supranasal (RPC, 100.00% vs. 75.00%), infranasal (RPC, 100.00% vs. 56.25%), infratemporal (RPC, 66.67% vs. 37.50%), and infranasal quadrants (retinal plexus, 83.33% vs. 56.25%) were significantly more in optic disc swelling group. The choriocapillaris vessel perfusion density increased after treatment in both groups. Conclusions. Decreases in vessel perfusion densities of the RPC and retinal plexus after treatment in VKH patients with optic disc swelling were more common than in those without optic disc swelling. The choriocapillaris vessel perfusion density increased after treatment, regardless of the presence/absence of optic disc swelling.

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“…The posterior uveitis affects the retina and/or the optic nerve, which probably leads to permanent loss of vision. Uveitis can be triggered by infections from bacteria and viruses [ 3 , 4 ], or by some systemic autoimmune diseases such as Behcet’s disease, lupus, Vogt–Koyanagi–Harada (VKH) disease [ 5 , 6 , 7 , 8 ]. However, the exact cause or the initiation of uveitis, and how inflammatory responses lead to retinal malfunction and vision loss, remain largely unknown.…”

Section: Introductionmentioning

confidence: 99%

Retinal Proteomic Analysis in a Mouse Model of Endotoxin-Induced Uveitis Using Data-Independent Acquisition-Based Mass Spectrometry

Zhang

et al. 2022

IJMS

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Uveitis is a group of sight-threatening ocular inflammatory diseases, potentially leading to permanent vision loss in patients. However, it remains largely unknown how uveitis causes retinal malfunction and vision loss. Endotoxin-induced uveitis (EIU) in rodents is a good animal model to study uveitis and associated acute retinal inflammation. To understand the pathogenic mechanism of uveitis and screen potential targets for treatment, we analyzed the retinal proteomic profile of the EIU mouse model using a data-independent acquisition-based mass spectrometry (SWATH-MS). After systemic LPS administration, we observed activation of microglial cells accompanied with the elevation of pro-inflammatory mediators and visual function declines. In total, we observed 79 upregulated and 90 downregulated differentially expressed proteins (DEPs). Among the DEPs, we found that histone family members (histone H1, H2A, H2B) and blood proteins including haptoglobin (HP), hemopexin (HPX), and fibrinogen gamma chain (FGG) were dramatically increased in EIU groups relative to those in control groups. We identified phototransduction and synaptic vesicle cycle as the top two significant KEGG pathways. Moreover, canonical pathway analysis on DEPs using Ingenuity Pathway Analysis revealed top three most significant enriched pathways related to acute phase response signaling, synaptogenesis signaling, and eif2 signaling. We further confirmed upregulation of several DEPs associated with the acute phase response signaling including HP, HPX, and FGG in LPS-treated retinas by qPCR and Western blot. In summary, this study serves as the first report to detect retinal proteome changes in the EIU model. The study provides several potential candidates for exploring the mechanism and novel therapeutic targets for uveitis and other retinal inflammatory diseases.

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Vogt-Koyanagi-Harada disease

Cited by 22 publications

References 62 publications

Choroidal thickening with serous retinal detachment in BRAF/MEK inhibitor-induced uveitis: A case report

Choroidal thickening with serous retinal detachment in BRAF/MEK inhibitor-induced uveitis: A case report

Changes of Peripapillary Capillary Density in Patients with Vogt–Koyanagi–Harada Disease Evaluated by Optical Coherence Tomography Angiography

Retinal Proteomic Analysis in a Mouse Model of Endotoxin-Induced Uveitis Using Data-Independent Acquisition-Based Mass Spectrometry

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