Vogt-Koyanagi-Harada Disease and Birdshot Retinochoroidopathy, Similarities and Differences: A Glimpse into the Clinicopathology of Stromal Choroiditis, a Perspective and a Review

Abstract

The purpose of this work was to give a comprehensive and updated review on two primary stromal choroiditis entities, Vogt-Koyanagi-Harada disease (VKH) and birdshot retinochoroiditis (BRC). Their appraisal has become much more precise thanks to new investigational methods, such as indocyanine green angiography (ICGA) and enhanced depth imaging optical coherence tomography (EDI-OCT), which give substantially improved imaging access to the choroid. In this review, we focus on the crucial changes brought by this progress in the understanding, diagnosis, and management of these disorders. Application of these methods makes it possible to reach an early diagnosis, therefore allowing early treatment, which has led to a profound improvement in outcomes when compared to previous management.

Zusammenfassung

Zweck dieser Arbeit war es, einen umfassenden und aktualisierten Überblick über 2 stromale Aderhautentzündungen (Choroiditis), Morbus Vogt-Koyanagi-Harada (VKH) und Birdshot-Retinochoroiditis (BRC), zu geben. Die Wahrnehmung von diesen 2 Aderhautentzündungen ist in der letzten Zeit viel präziser geworden dank neuer Investigationsmethoden wie Indocyaningrünangiografie (ICGA) und „Enhanced Depth Imaging Optical Coherence Tomography“ (EDI-OCT). Diese Methoden erlauben einen wesentlich besseren bildgebenden Zugang zu den Aderhautstrukturen. In diesem aktualisierten Überblick konzentrieren wir uns speziell auf die entscheidenden Änderungen, die diese Fortschritte zustande gebracht haben, was Verständnis, Diagnose und Behandlung dieser Erkrankungen anbelangt. Anwendung dieser Methoden macht es möglich, eine frühe Diagnose zu stellen, was wiederum eine frühe und aggressive Therapie ermöglicht. Solch eine Haltung hat zu einer signifikanten Verbesserung des Verlaufs gegenüber der gegenwärtig immer noch praktizierten Haltung erbracht. Ähnlichkeiten und Differenzen werden analysiert.

Key words

birdshot retinochoroiditis - Vogt-Koyanagi-Harada disease - stromal choroiditis - indocyanine green angiography - immunosuppressive therapy

Schlüsselwörter

Birdshot-Retinochoroiditis - Morbus Vogt-Koyanagi-Harada - stromale Aderhautentzündung - Indocyaningrünangiografie - immunosuppressive Therapie

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