Echographic features of the Vogt-Koyanagi-Harada syndrome

Vogt-Koyanagi-Harada (VKH) syndrome represents a spectrum of bilateral panuveitis with associated central nervous system and dermatologic manifestations. The diagnosis is based on clinical and angiographic findings, but some of the characteristic features may be either absent or difficult to visualize in the presence of opaque media. With the use of standardized echography (standardized A-scan and contact B-scan echography), we examined nine patients with clear media and clinical evidence of VKH syndrome. Consistent echographic findings included (1) diffuse, low to medium reflective thickening of the choroid posteriorly; (2) serous retinal detachment, located inferiorly or in the posterior pole; (3) mild vitreous opacities with no posterior vitreous detachment; and (4) thickening of the sclera and/or episclera posteriorly. Resolution of these findings occurred with systemic corticosteroid therapy. Standardized echography should be considered an important diagnostic tool in VKH syndrome, especially when visualization of the fundus is poor or when clinical presentation is atypical.