Vogt-Koyanagi-Harada Syndrome Manifestations and Diagnosis

Introduction

Vogt-Koyanagi-Harada (VKH) syndrome is a rare multisystemic idiopathic disorder that affects tissues with melanocytes. The exact cause remains unknown. It is a diffuse bilateral granulomatous panuveitis that is frequently accompanied by neurological, auditory and dermatological alterations [1]. The diagnosis is a challenge because of the rarity of VKH syndrome and it is based mainly on clinical criteria, with supportive evidence from ancillary tests. We hereby report two VKH syndrome cases, diagnosed and successfully treated.

References

• 1 Moorthy R S, Inomata H, Rao N A. Vogt-Koyanagi-Harada syndrome.  Surv Ophthalmol. 1995;  39 265-292
• 2 Wakabayashi T, Morimura Y, Miyamoto Y et al. Changing patterns of intraocular inflammatory disease in Japan.  Ocul Immunol Inflamm. 2003;  11 277-286
• 3 Rajendram R, Evans M, Rao N A. Vogt-Koyanagi-Harada disease.  Int Ophthalmol Clin. 2005;  45 115-134
• 4 Levinson R D, See R F, Rajalingam R et al. HLA-DRB1 and -DQB1 alleles in mestizo patients with Vogt-Koyanagi-Harada’s disease in Southern California.  Hum Immunol. 2004;  65 1477-1482
• 5 Read R W, Rao N A. Utility of existing Vogt-Koyanagi-Harada syndrome diagnostic criteria at initial evaluation of the individual patient: a retrospective analysis.  Ocul Immunol Inflamm. 2000;  8 227-234
• 6 Read R W, Holland G N, Rao N A et al. Revised diagnostic criteria for Vogt-Koyanagi-Harada disease: report of an international committee on nomenclature.  Am J Ophthalmol. 2001;  131 647-652
• 7 Friedman A H, Deutsh-Sokol R H. Sugiura’s sign. Perilimbal vitiligo in the Vogt-Koyanagi-Harada syndrome.  Ophthalmology. 1981;  88 1159-1165
• 8 Kishi A, Nao-i N, Sawada A. Ultrasound biomicroscopic findings of acute angle-closure glaucoma in Vogt-Koyanagi-Harada syndrome.  Am J Ophthalmol. 1996;  122 735-737
• 9 Arellanes-García L, Hernández-Barrios M, Fromow-Guerra J et al. Fluorescein fundus angiographic findings in Vogt-Koyanagi-Harada syndrome.  Int Ophthalmol. 2007;  27 155-161
• 10 Maruyama Y, Kishi S. Tomographic features of serous retinal detachment in Vogt-Koyanagi-Harada syndrome.  Ophthalmic Surg Lasers Imaging. 2004;  35 239-242