Vogt-Koyanagi-Harada syndrome

Moorthy, Ramana S.; Inomata, Hajime; Rao, Narsing A.

doi:10.1016/s0039-6257(05)80105-5

Cited by 631 publications

(659 citation statements)

References 80 publications

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“…1 The exact cause of VKH disease remains unknown, but evidence suggests that it involves a T-lymphocyte-mediated autoimmune process directed against one or more antigens found on or associated with melanocytes. Several studies demonstrated that tyrosinase family proteins are the antigens specific to VKH disease [2][3][4][5] and that VKH disease is characterized by a T helper type 1 cell-mediated immune response.…”

Section: Introductionmentioning

confidence: 99%

“…The occurrence of these complications is known to be associated with a worse visual outcome. 1,8,9 The principles of therapy of VKH disease are to suppress the initial intraocular inflammation with early and aggressive use of systemic corticosteroids, followed by slow tapering. Such treatment may shorten the duration of the disease, may prevent progression into the chronic stage, and may reduce the incidence of extraocular manifestations as well.…”

Section: Introductionmentioning

confidence: 99%

“…Such treatment may shorten the duration of the disease, may prevent progression into the chronic stage, and may reduce the incidence of extraocular manifestations as well. 1,10 VKH disease predominately occurs in women in their third to fourth decades of life at onset of the illness. 1 However, VKH disease can occur in the paediatric population, but the prognosis in this subpopulation appears to be quite variable.…”

Section: Introductionmentioning

confidence: 99%

“…1,10 VKH disease predominately occurs in women in their third to fourth decades of life at onset of the illness. 1 However, VKH disease can occur in the paediatric population, but the prognosis in this subpopulation appears to be quite variable. 8,[11][12][13] It is possible that differences in interval between onset of uveitis and starting treatment, type of treatment, and/or duration of treatment could have played a role in the differences in outcomes reported by previous studies.…”

Section: Introductionmentioning

confidence: 99%

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Vogt-Koyanagi-Harada disease in children

El‐Asrar

Alkharashi

Aldibhi

et al. 2007

Eye

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Purpose To identify prognostic factors for outcome in children with Vogt-Koyanagi-Harada (VKH) disease. Methods All children 16 years and younger with acute uveitis associated with VKH disease treated between 1999 and 2006 were reviewed. Results Twenty-three children (46 eyes) were identified; 20 (87%) girls and three (13%) boys with a mean age at presentation of 12.572.4 years. Mean follow-up period was 48.6730.8 months. Visual acuity of 20/40 or better was achieved in 38 (82.6%) eyes. Eleven eyes developed at least one complication, including cataract in eight eyes, glaucoma in eight eyes, subretinal neovascular membranes in two eyes, and subretinal fibrosis in one eye. Disease recurred during follow-up in 18 eyes. Development of complications was negatively associated with final visual acuity of 20/20 (P ¼ 0.0317). Shorter interval between symptoms and treatment was a predictor of final visual acuity of 20/20 (odds ratio ¼ 10.4; 95% confidence interval ¼ 1.61-67.3). Recurrence of inflammation was significantly associated with development of complications (P ¼ 0.003), worse visual acuity (P ¼ 0.022) and presence of posterior synechiae of the iris at presentation (P ¼ 0.0083), longer interval between symptoms and treatment (P ¼ 0.013), initial treatment with intravenous corticosteroids (P ¼ 0.0012), and rapid tapering of corticosteroids (P ¼ 0.0063). Conclusion Visual prognosis of VKH in children is generally favourable. Clinical findings at presentation, development of complications, interval between symptoms and treatment, recurrence of inflammation, use of intravenous corticosteroids, and method of tapering of systemic corticosteroids were significant prognostic factors.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Vogt-Koyanagi-Harada disease in children

El‐Asrar

Alkharashi

Aldibhi

et al. 2007

Eye

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“…Vogt-Koyanagi-Harada (VKH) disease is a granulomatous inflammatory disorder affecting pigmented structures, i.e., eye, inner ear, meninges, and skin [1]. The choroid is the main site of autoimmune inflammation in ocular tissue [2].…”

Section: Introductionmentioning

confidence: 99%

Recurrent Vogt–Koyanagi–Harada disease with sensorineural hearing loss and choroidal thickening

et al. 2013

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Purpose We report a case of Vogt-Koyanagi-Harada (VKH) disease that recurred with sensorineural hearing loss and choroidal thickening. MethodsWe measured the choroidal thickness using enhanced-depth imaging optical coherence tomography (EDI-OCT) in a patient with VKH during corticosteroid-tapering therapy.Results A 71-year-old man presented with fever, headache, and anorthopia associated with wavy choroidal folds and a serous retinal detachment (SRD). The EDI-OCT images showed choroidal thickening (> 600 μm at the subfovea), and he was diagnosed with VKH disease. After treatment with pulsed intravenous methylprednisolone, the choroidal folds and SRD resolved and the choroidal thickness decreased. About 6 months after subsequent treatment with an oral corticosteroid started, headache, tinnitus, and sensorineural hearing loss developed, and increased choroidal thickness was observed without other evidence of increased ocular inflammation. A high-dose corticosteroid was injected and tapered, and the sensorineural hearing loss improved immediately and the choroidal thickness decreased. Ishibazawa et al. 4Conclusions In the current case, sensorineural hearing loss occurred with recurrent VKH disease; however, there were no ocular inflammatory signs except for rebound choroidal thickening. Measuring the choroidal thickness using EDI-OCT can sensitively identify recurrent VKH disease.

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