Original articleConcomitant Choroidal Inflammation during Anterior Segment Recurrence in Vogt-Koyanagi-Harada Disease
Section snippets
Inclusion Criteria
This was an interventional retrospective case series conducted at the Singapore National Eye Centre (SNEC) from January 1, 2003 through December 31, 2006. All patients diagnosed with VKH disease based on the diagnostic criteria proposed by the International Committee3 in 2001 were identified from the SNEC uveitis database. Patients who had anterior segment recurrence and satisfied the following criteria were included: 1) presence of anterior chamber (AC) inflammation of at least 1+ cells after
Patient Characteristics and Previous Ocular History
Twelve eyes of nine patients who satisfied the inclusion criteria were studied. Three patients had bilateral involvement. There were five men and four women. All were Chinese except for one Malay patient. The mean age ± standard deviation (SD) was 54.0 ± 9.9 years (range, 47 to 67 years). The patients had been diagnosed with VKH disease for a mean ± SD of 11.6 ± 8.0 years (range, two to 23 years). Four patients were classified as having complete VKH disease, whereas the rest were categorized as
Discussion
Depigmentation of ocular and cutaneous structures is a common feature of chronic VKH disease. However, the development of sunset glow fundus, peripapillary atrophy, or both despite apparent control of ocular inflammation suggests ongoing subclinical choroidal inflammation. In a histopathologic analysis of four eyes with sunset glow fundus in two patients with VKH disease, scattered infiltration of predominantly T-lymphocytes (30% B-lymphocytes) in the thickened choroid with notable
Dr Kristine Bacsal earned her medical degree from the University of the Philippines, and underwent residency training in ophthalmology at the Philippine General Hospital. She subspecialized in Ocular Inflammation and Immunology at the Singapore National Eye Institute under the mentorship of Prof Soon Phaik Chee.
References (11)
- et al.
Vogt-Koyanagi-Harada Syndrome
Surv Ophthalmol
(1995) - et al.
Revised diagnostic criteria for Vogt-Koyanagi-Harada disease: report of an International Committee on Nomenclature
Am J Ophthalmol
(2001) - et al.
Indocyanine green angiographic findings in Vogt-Koyanagi-Harada disease
Am J Ophthalmol
(1996) - et al.
The contribution of indocyanine green angiography to the appraisal and management of Vogt-Koyanagi-Harada disease
Ophthalmology
(2001) Quantitative evaluation of “sunset glow” fundus in Vogt-Koyanagi-Harada disease
Jpn J Ophthalmol
(1999)
Cited by (59)
Choroidal imaging in uveitis: An update
2022, Survey of OphthalmologyCitation Excerpt :Fuzzy choroidal vessels and HDDs showed similar patterns in both diseases and are characteristic findings of stromal choroiditis on ICGA.12 Indocyanine green angiography has been proven to be useful in identifying occult recurrences in clinically quiescent disease, cases with only neurological signs as well as those with only anterior segment inflammation.10,17,41,128 In VKH, FA and OCT show findings that are already clinically apparent, while ICGA identifies choroidal inflammation before it spills over to the retina.99
Chorioretinal Inflammatory Non-Infectious Diseases
2017, Choroidal DisordersChoroidal Histopathology
2017, Choroidal DisordersResearch progress of optical coherence tomography and optical coherence tomography angiography in noninfectious uveitis: a review
2023, Chinese Journal of Ophthalmology
Dr Kristine Bacsal earned her medical degree from the University of the Philippines, and underwent residency training in ophthalmology at the Philippine General Hospital. She subspecialized in Ocular Inflammation and Immunology at the Singapore National Eye Institute under the mentorship of Prof Soon Phaik Chee.
Associate Professor Soon Phaik Chee received her ophthalmology training from the National University of Singapore. She underwent subspeciality training in Ocular Inflammation and Immunology at the Moorfield’s Eye Hospital. She is now a senior consultant and head of the Ocular Inflammation and Immunology service of the Singapore National Eye Centre.