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Vogt-Koyanagi-Harada disease
Uvea
Key Points
- •VKH is a bilateral granulomatous panuveitis affecting melanocyte-containing tissues - uvea, meninges, inner ear, skin; histopathologically identical to sympathetic ophthalmia, distinguished only by absence of penetrating ocular trauma
- •Revised Diagnostic Criteria (2001): Complete VKH requires all 5 criteria - no trauma, bilateral ocular involvement, plus neurological/auditory AND integumentary features
- •Most common in pigmented races (Japanese, Hispanic, South Asian); female predominance (2:1); HLA-DRB1*0405 is the strongest genetic risk factor (OR ~10)
- •Sunset-glow fundus and Sugiura sign are convalescent/chronic findings indicating prior inadequate treatment - they are preventable with early aggressive immunosuppression
- •Early IMT within 2 weeks alongside high-dose steroids reduces recurrence from 40–70% (steroids alone) to 10–20%; EDI-OCT choroidal thickness is the best biomarker for subclinical activity
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17 more sections are included with the Clinical plan.
- Definition
- Epidemiology
- Aetiology and causes
- Pathogenesis
- Classification
- Risk factors and associations