Related Experiment Videos
Extensive chorioretinal atrophy in Vogt-Koyanagi-Harada disease
1Department of Ophthalmology, Kagoshima University Faculty of Medicine, Sakuragaoka, Japan.
Insights
Inadequate initial treatment of Vogt-Koyanagi-Harada (VKH) disease can cause chronic uveitis. This can lead to severe vision loss from extensive chorioretinal atrophy over time.
Area of Science:
- Ophthalmology
- Immunology
Background:
- Vogt-Koyanagi-Harada (VKH) disease is a systemic autoimmune disorder affecting the eyes.
- Early and adequate treatment is crucial for managing VKH disease and preventing long-term complications.
Observation:
- This study followed four patients with VKH disease for over 10 years.
- Patients initially presented with classic VKH symptoms, with one case showing acute angle-closure glaucoma as the first sign.
Findings:
- Two patients received initial corticosteroid treatment, experiencing recurrent uveitis over 13-34 years.
- All patients eventually developed diffuse, extensive chorioretinal atrophy, leading to significant visual impairment.
Implications:
- Delayed or insufficient corticosteroid therapy in VKH disease can result in chronic uveitis.
- Prolonged inflammation may cause irreversible chorioretinal degeneration and severe vision loss.
Purpose:
To report extensive chorioretinal atrophy during the long-term course of Vogt-Koyanagi-Harada (VKH) disease not treated properly in the initial phase.
Cases:
Four patients with VKH disease were examined more than 10 years after onset of the disease.
Observations:
They presented initially with classic features of VKH disease, except 1 patient who had developed bilateral, acute angle-closure glaucoma as the initial sign. Two patients received systemic corticosteroid therapy at the acute phase of the disease. During the follow-up of 13-34 years subsequent to onset, these patients had chronic recurrent anterior uveitis with apparently stable depigmented fundus. Eventually, they developed diffuse, extensive chorioretinal atrophy that resulted in severe visual loss. One patient had an unusual familial occurrence of the disease.
Conclusions:
Failure to prescribe proper corticosteroid therapy in the initial phase of VKH disease may lead to chronic recurrent uveitis. Long-standing uveitic reactions may eventually result in severe visual loss due to extensive chorioretinal degeneration.