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Vogt-Koyanagi-Harada disease after head trauma
M Accorinti1, M P Pirraglia, C Corsi
1Department of Ophthalmology, Ocular Immunovirology Service, University of Roma La Sapienza, Roma, Italy. massimo.accorinti@tiscalinet.it
European Journal of Ophthalmology
|October 13, 2007
Summary
Vogt-Koyanagi-Harada disease can be triggered by closed head trauma. This suggests that trauma to melanocyte-rich tissues may cause ocular inflammation.
Area of Science:
- Ophthalmology
- Neurology
Background:
- Vogt-Koyanagi-Harada disease is a rare autoimmune disorder affecting melanin-rich tissues.
- The etiology of Vogt-Koyanagi-Harada disease is not fully understood, but autoimmune and infectious triggers are suspected.
Observation:
- Two patients presented with neurological and auditory symptoms following closed head trauma.
- Both patients subsequently developed bilateral uveitis with retinal detachment, characteristic of Vogt-Koyanagi-Harada disease.
- Ocular lesions responded to high-dose steroid therapy but recurred upon dose reduction.
Findings:
- The clinical course, including fundus depigmentation and pigment clumping, confirmed Vogt-Koyanagi-Harada disease in both cases.
- One patient experienced a concurrent ocular and auditory relapse, further supporting the diagnosis.
- The disease onset after head trauma suggests a potential link between trauma and autoimmune ocular inflammation.
Implications:
- Closed head trauma may act as a trigger for Vogt-Koyanagi-Harada disease.
- This case series highlights the potential for indirect trauma to melanocyte-containing tissues to induce ocular inflammatory responses.
- Further research is warranted to elucidate the mechanisms linking head trauma and Vogt-Koyanagi-Harada disease.
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