Vogt-Koyanagi-Harada

Vogt-Koyanagi-Harada disease (VKH) is a rare autoimmune disease that affects multiple systems in the body, including the eyes, ears, skin, and the central nervous system. The disease is characterized by bilateral uveitis, which can lead to complications such as glaucoma, cataract, and vision loss. Other symptoms may include hearing loss, vertigo, and skin changes such as vitiligo and alopecia.

Etiology

The exact cause of VKH is unknown, but it is believed to be an autoimmune response against melanocytes, the cells that produce melanin. This response is thought to be triggered by a viral infection or other environmental factors in genetically susceptible individuals. The disease is more common in certain populations, such as those of Asian, Hispanic, and Native American descent.

Clinical Presentation

Patients with VKH typically present with a sudden onset of symptoms, which may include severe eye pain, blurred vision, and sensitivity to light. Other symptoms may include hearing loss, tinnitus, vertigo, and skin changes such as vitiligo and alopecia. Neurological symptoms such as headache, neck stiffness, and meningismus may also be present.

Diagnosis

The diagnosis of VKH is based on clinical findings and the exclusion of other diseases. Diagnostic criteria include bilateral uveitis, neurological and auditory findings, and skin changes. Additional tests such as fluorescein angiography, optical coherence tomography, and audiometry may be used to confirm the diagnosis.

Treatment

Treatment for VKH is aimed at reducing inflammation and preventing complications. This typically involves the use of corticosteroids, either orally or through injections. Other immunosuppressive agents may be used in severe cases or in patients who do not respond to corticosteroids. Regular follow-up with an ophthalmologist is important to monitor for complications such as glaucoma and cataract.

Prognosis

The prognosis for VKH is generally good with early diagnosis and treatment. However, complications such as glaucoma, cataract, and vision loss can occur and may lead to permanent disability. Regular follow-up with an ophthalmologist is important to monitor for these complications.

See Also

• Uveitis
• Autoimmune disease
• Melanin
• Glaucoma
• Cataract

Vogt-Koyanagi-Harada Resources
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