“Revised diagnostic criteria” for Vogt-Koyanagi-Harada disease fail to improve disease management

Hedayatfar, Alireza; Khochtali, Sana; Khairallah, Moncef; Takeuchi, Masaru; Asrar, A Abu El; Herbort, Carl P.

doi:10.1016/j.joco.2018.10.011

Cited by 18 publications

(17 citation statements)

References 35 publications

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“…In order to standardise the appraisal of VKH cases, there have been several attempts to fix diagnostic criteria, the last at the turn of the century [ 119 ]. These criteria are however inadequate because the distinction between initial-onset and chronic disease have not been taken into account and new choroidal imaging methods have not been used [ 120 , 121 ]. The use of these criteria has therefore been of limited utility and new criteria are presently being published, taking into account both the distinction of initial-onset and chronic diseases as well as the performing diagnostic tools available to image choroidal inflammation ( Table 6 ).…”

Section: Icga-derived Classification and Clinicopathological Mechanisms In Non-infectious Choroiditis And Specific Entitiesmentioning

confidence: 99%

Classification of Non-Infectious and/or Immune Mediated Choroiditis: A Brief Overview of the Essentials

Herbort¹,

Mantovani

Tuğal-Tutkun

et al. 2021

Diagnostics

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The choroid was poorly accessible to imaging investigation until the last decade of the last century. With the availability of more precise imaging methods such as indocyanine green angiography (ICGA) and, later, optical coherence tomography (OCT), enhanced depth OCT (EDI-OCT), and OCT angiography (OCTA), appraisal of choroidal inflammation has substantially gained in accuracy. This allowed to precisely determine which structures were touched in the different non-infectious choroiditis entities and made it possible to classify this group of diseases, ICGA signs, mainly hypofluorescent lesions, were identified and described. Previous publications have divided angiographic findings into two main sets of signs: (1) irregular “geographic” hypofluorescent areas corresponding to choriocapillaris non-perfusion and (2) round more regular, hypofluorescent dark dots more evenly distributed in the fundus corresponding to more deep choroidal stromal foci. These distinct findings allowed to subdivide and classify choroiditis into choriocapillaritis and stromal choroiditis. Additional signs were identified from EDI-OCT and OCTA examination supporting the classification of choroiditis into choriocapillaritis and stromal choroiditis. Results: Diseases involving principally the choriocapillaris included Multiple Evanescent White Dot Syndrome (MEWDS), Acute Posterior Multifocal Placoid Pigment Epitheliopathy (APMPPE), Idiopathic Multifocal Choroiditis (MFC), and Serpiginous Choroiditis (SC) as well as mixed forms. Diseases primarily involving the choroidal stroma included HLA-A29 Birdshot Retinochoroiditis (BRC), Vogt-Koyanagi-Harada disease (VKH), Sympathetic Ophthalmia (SO), and Sarcoidosis chorioretinitis (SARC). Thanks to new imaging investigations of the choroid, it is now possible to classify and understand the diverse clinicopathological mechanisms in the group of non-infectious choroiditis entities.

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Section: Icga-derived Classification and Clinicopathological Mechanisms In Non-infectious Choroiditis And Specific Entitiesmentioning

confidence: 99%

Classification of Non-Infectious and/or Immune Mediated Choroiditis: A Brief Overview of the Essentials

Herbort¹,

Mantovani

Tuğal-Tutkun

et al. 2021

Diagnostics

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“…Contrarily to the chronic form of the disease, patients are diagnosed at the early stage of disease or at acute early onset of the disease when diagnosis and treatment are performed within 3 weeks of symptoms [15].…”

Section: Patient Selectionmentioning

confidence: 99%

Vogt-Koyanagi-Harada disease: a retrospective and multicentric study of 41 patients

Diallo

Revuz²,

Clavel-Refregiers

et al. 2020

BMC Ophthalmol

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Background East and South East Asian subjects as well as Amerindians and Hispanic subjects are predominantly affected by Vogt-Koyanagi-Harada disease. In Europe, only few studies have described the clinical features and treatment of this disease, especially in France. Methods This retrospective case series was based on data collected from patients with a VKH disease diagnosed from January 2000 to March 2017, provided by three French Tertiary Centers. Results Forty-one patients (16 men and 25 women) were diagnosed: average age at diagnosis was 38.7 years. Patients were mainly from Maghreb (58%), but ethnic origins were multiple. Pleiocytosis was observed in 19 cases (63%) and 17 out of 41 patients showed audio vestibular signs (41%), and 11 showed skin signs (27%). Thirty-four were treated with corticosteroids (83%), 11 with an immunosuppressant treatment (27%) and 5 with biological therapy drugs (13%). Relapse was observed in 41% patients, even though final average visual acuity had improved. We did not find any significant clinical difference in the population from Maghreb compared to other populations, but for age and sex trends, since there was a majority of younger women. Conclusion We report here the second largest French cohort reported to date to our knowledge. The multiethnicity in our study suggests that VKH disease should be evoked whatever patients’ ethnicity.

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“…Again a consensus workshop failed to include in their report on “the revised diagnostic criteria of VKH” the single most important imaging investigational method, ICGA, for a disease originating exclusively and involving principally the choroid [ 6 ]. It is very well established that VKH cannot be precisely followed without the use of investigational imaging of the choroidal compartment [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Advances and potential new developments in imaging techniques for posterior uveitis Part 2: invasive imaging methods

Herbort¹,

Tuğal-Tutkun

Mantovani

et al. 2020

Eye

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The aim of this review was to identify the imaging methods at our disposal to optimally manage posterior uveitis at the present time. The focus was put on methods that have become available since the 1990s, some 30 years after fluorescein angiography had revolutionised imaging of posterior uveitis in particular imaging of the retinal vascular structures in the 1960s. We have focussed our review on precise imaging methods that have been standardised and validated and can be used universally thanks to commercially produced and available instruments for the diagnosis and follow-up of posterior uveitis. The second part of this imaging review will deal with invasive imaging methods and in particular ocular angiography.

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“Revised diagnostic criteria” for Vogt-Koyanagi-Harada disease fail to improve disease management

Cited by 18 publications

References 35 publications

Classification of Non-Infectious and/or Immune Mediated Choroiditis: A Brief Overview of the Essentials

Classification of Non-Infectious and/or Immune Mediated Choroiditis: A Brief Overview of the Essentials

Vogt-Koyanagi-Harada disease: a retrospective and multicentric study of 41 patients

Advances and potential new developments in imaging techniques for posterior uveitis Part 2: invasive imaging methods

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