Diagnostic perspectives and treatment efficacy in the Vogt-Koyanagi-Harada disease

Cover Page

Abstract


Vogt-Koyanagi-Harada (VKH) disease should be part of the differential diagnosis of a bilateral granulomatous uveitis. VKH is more common in the Mongoloid race (most frequently in Japanese, American Indians), and people of Hispanic descent. In Europeans, it is rare; mostly in women aged 30-50 with dark skin and hair pigmentation. The prodromal stage of VKH disease is non-specific but may include headache, vomiting and general malaise. Indocyanine green angiography may be helpful in making the diagnosis. Presenting a clinical case, the authors discuss the methods for diagnosis and follow-up for patients with Vogt-Koyanagi-Harada disease. Effective and timely treatment with high dose corticosteroids, if necessary in combination with immunosuppression, could save good visual functions.

About the authors

Yuriy Sergeyevich Astakhov

Pavlov State Medical University of St. Petersburg

Email: astakhov73@mail.ru
MD, doctor of medical science, professor. Department of Ophthalmology

Tatyana Igorevna Kuznetcova

Pavlov State Medical University of St. Petersburg

Email: brionika@gmail.com
MD, Postgraduate student. Department of Ophthalmology

Kirill Vladimirovich Khripun

Pavlov State Medical University of St. Petersburg

Email: kirdoc@mail.ru
MD, Department of Ophthalmology

Yanina Stanislavovna Konenkova

City versatile hospital N 2

Email: Krokon@mail.ru
MD, head of the eye microsurgery department N 4

Yekaterina Vyacheslavovna Belozerova

Diagnostic center N 7 (ophthalmological) for adults and children

Email: belozerova.ekaterina.88@mail.ru
MD, ophthalmologist

References

  1. Катаргина Л. А., Денисова Е. В., Старикова А. В., Гвоздюк Н. А. Клинические особенности и результаты лечения увеитов, ассоциированных с синдромом Фогта-Коянаги-Харада у детей. Офтальмологические ведомости. 2012; 5 (1): 36-44.
  2. Мамбеткулова Г. К., Ишбердина Л. Ш., Мальханов В. Б. Иммунологические и иммуногенетические особенности увеитов при синдроме Фогта-Коянаги-Харада. Русский медицинский журнал. Доступен по: http://www.rmj.ru/articles_4911.htm.
  3. Сенченко Н. Я., Щуко А. Г., Малышев В. В. Увеиты: руководство. М.: ГЕОТАР-Медиа; 2010.
  4. Abad S., Wieërs G., Colau D., Wildmann C. Absence of recognition of common melanocytic antigens by T cells isolated from the cerebrospinal fluid of a Vogt-Koyanagi-Harada patient. Mol. Vis., 2014; 2 (20): 956-69.
  5. Gupta A., Gupta V., Herbort C. P., Khairallah M. Uveitis: text and imaging. 1 sted. ND: 2009.
  6. Herbort С. P. Болезнь Фогта-Коянаги-Харада. XVIII Международный офтальмологический конгресс «Белые ночи»: тез. докл. Санкт-Петребург; 2012.
  7. Herbort C. P., Mochizuki M. Vogt-Koyanagi-Harada disease: inquiry into the genesis of a disease name in the historical context of Switzerland and Japan. Int. Ophthalmol. 2007; 27 (2-3): 67-79.
  8. Kawaguchi T., Horie S., Bouchenaki N. Suboptimal therapy controls clinically apparent disease but not subclinical progression of Vogt-Koyanagi-Harada disease. Int. Ophthalmol. 2010; 30 (1): Р. 41-50.
  9. Miyanaga M., Kawaguchi T., Shimizu K. Influence of early cerebrospinal fluid-guided diagnosis and early high-dose corticosteroid therapy on ocular outcomes of Vogt-Koyanagi-Harada disease. Int. Ophthalmol. 2007; 27 (2-3): 183-8.
  10. Moorthy R. S., Inomata H., Rao N. A. Vogt-Koyanagi-Harada syndrome. Surv Ophthalmol. 1995; 39 (4): 265-92.
  11. Nussenblatt R. B., Whitcup S. M. Uveitis: Fundamentals and Clinical Practice. 4th ed. Elsevier, 2010.
  12. Rao N. A., Sukavatcharin S., Tsai J. H. Vogt-Koyanagi-Harada disease diagnostic criteria. Int. Ophthalmol. 2007; 27 (2-3): 195-9.
  13. Rubsamen P. E., Gass J. D. Vogt-Koyanagi-Harada syndrome. Clinical course, therapy, and long-term visual outcome. Arch Ophthalmol, 1991; 109 (5): 682-7.
  14. Wang Y., Chan C. C. Gender differences in Vogt-Koyanagi-Harada disease and sympathetic ophthalmia. Ophthalmology. 2014; 2014: 157803.

Statistics

Views

Abstract - 606

PDF (Russian) - 916

Cited-By


PlumX


Copyright (c) 2014 Astakhov Y.S., Kuznetcova T.I., Khripun K.V., Konenkova Y.S., Belozerova Y.V.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies