Vogt-Koyanagi-Harada Syndrome in a Healthy African-American Woman: Case Report and Review of Literature

Abstract

A previously healthy 18 year-old African-American female presented with unilateral vision loss associated with headaches. Initial ocular examination revealed an exudative retinal detachment involving the macula, disc edema, and choroidal striae worse in the right than the left eye. Fluorescein angiography showed multiple punctate hyperfluorescent lesions with leakage into the subretinal space. Extensive work up led to the diagnosis of VogtKoyanagi-Harada syndrome. The patient was treated with a prolonged taper of systemic prednisone and approximately 4 months after presentation, vision improved to 20/20 in the right eye and 20/25 in the left eye.

Incomplete Vogt-Koyanagi-Harada in a 14-year-Old African American female with bilateral disc edema

“…VKH is most commonly seen amongst individuals with pigmented skin such as Asians, Native Americans, Middle eastern and Hispanics. 1 However, the disease is relatively uncommon in Africans and Caucasians. 1 VKH often presents in the third to fifth decade of life and it is more predominant in females.…”

“… 1 However, the disease is relatively uncommon in Africans and Caucasians. 1 VKH often presents in the third to fifth decade of life and it is more predominant in females. 1 Our patient is a 14-year-old African American female, which makes her an unusual case of VKH given her age and ethnicity.…”

“…Vogt-Koyanagi-Harada (VKH) disease is a multisystem disease with auditory, neurologic, ocular, and dermatologic manifestations. 1 , 2 Although the true pathophysiology of the disease is not well understood, current leading theories suggest an autoimmune T-cell mediated process against melanocytes. 1 VKH classically presents as bilateral panuveitis as well as extraocular manifestations such as meningismus, alopecia, poliosis, vitiligo, and dysacousia.…”

“… 1 VKH classically presents as bilateral panuveitis as well as extraocular manifestations such as meningismus, alopecia, poliosis, vitiligo, and dysacousia. 1 The disease mainly affects pigmented individuals. 1 It has been reported to occur less frequently in African Americans when compared to other ethnicities, including Hispanics, Native Americans, Asians, and Middle Easterners.…”

“… 1 The disease mainly affects pigmented individuals. 1 It has been reported to occur less frequently in African Americans when compared to other ethnicities, including Hispanics, Native Americans, Asians, and Middle Easterners. 1 , 4 …”