Clinical Characteristics of Vogt–Koyanagi–Harada Syndrome in Chinese Patients

Effects of the duration of initial oral corticosteroid treatment on the recurrence of inflammation in Vogt-Koyanagi-Harada disease

“…3,13-17 Yang et al 13 showed that the duration of VKH at presentation is an important factor for the development of glaucoma and ocular hypertension. Chee et al 14 also demonstrated that the use of high-dose systemic prednisolone within 2 weeks of initial presentation will result in significantly fewer ocular complications compared with those who received systemic steroid after 4 weeks.…”

Vogt-Koyanagi-Harada Disease

“…33 CSCR is a common misdiagnosis in patients with VKH disease, especially early during the acute uveitic phase of the condition when vitreous and anterior chamber inflammation are either absent or mild. 14 Finally, Garza Leon et al described a 37-year-old Mexican woman of undisclosed race who was noted to have a persistent tonic pupil and absent lower extremity reflexes, or Holmes-Adie syndrome, concurrent with the acute uveitic phase of VKH disease. 26 Salient initial ocular findings included moderately severe bilateral panuveitis, as well as disc edema and hyperemia with serous retinal detachment in each eye.…”

Catching the therapeutic window of opportunity in early initial-onset Vogt–Koyanagi–Harada uveitis can cure the disease

“…A recent publication reported a high percentage of clinical recurrence in VKH patients given early high-dose corticosteroids with slow taper, as 79% of patients progressed to chronic recurrent disease and 38% developed subretinal fibrosis [18]. Additional studies by Chee et al [19], and Keino et al [20], showed that steroid monotherapy given at initial-onset disease was incapable of preventing chronic evolution, which is significantly associated with more severe anterior segment inflammation, has a worse visual acuity [12], a worse mean retinal sensitivity [21] and more frequent complications compared with initial-onset acute VKH disease receiving appropriate therapy [11,12,21]. Moreover, it was shown that chronic recurrent disease was far more refractory to treatment [21].…”

“…It is considered a primary stromal choroiditis because the inflammatory reaction electively starts within the choroidal stroma [9]. The initial-onset acute disease typically exhibits granulomatous choroiditis with exudative retinal detachment and optic disk hyperemia and swelling, followed by anterior segment involvement and eventual development into chronic recurrent granulomatous anterior uveitis if not properly treated, with typical ''sunset glow fundus'' (SGF) and chorioretinal atrophy [10][11][12][13].…”

“…Intraocular inflammation in insufficiently treated VKH disease will proceed to recurrent granulomatous anterior and posterior uveitis and typical sunset glow fundus (SGF), even when systemic monotherapy is given early in disease [10][11][12][13][14][15][16].…”