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[Vogt-Koyanagi-Harada syndrome (clinical cases)]. 2015

E L Sorokin, and N V Voronina, and S Yu Avramenko, and N V Pomytkina
Khabarovsk branch of the Academician S.N. Fyodorov IRTC 'Eye Microsurgery', 211 Tikhookeanskaya St., Khabarovsk, Russian Federation, 680033; Far Eastern State Medical University, 35 Muravyeva-Amurskogo St., Khabarovsk, Russian Federation, 680000.

OBJECTIVE to analyze two female cases of Vogt-Koyanagi-Harada (VKH) syndrome. METHODS The first patient presented with bilateral panuveitis and unilateral keratomalacia (left eye). For the latter, blepharorrhaphy was performed. Methylprednisolone (Metypred) and azathioprine pulses, subsequently switched to oral therapy, caused regression of uveitis. In 1 month the patient was operated for retinal detachment and associated cataract in her right eye. The second patient presented with bilateral detachment of neuroepithelium. Complete reattachment in both eyes was achieved with Metypred pulses followed by oral prednisolone and azathioprine. Bilateral panuveitis with pupil occlusion developed 6 months after the cessation of prednisolone, however, began to resolve as soon as the treatment was resumed. RESULTS Timely diagnosis and combination pulse therapy (methylprednisolone and azathioprine) enabled rapid resolution of acute condition. CONCLUSIONS Pulse Metypred is the mainstay of the treatment of VKH syndrome. Supplementing the treatment of autoimmune uveitis with low doses of azathioprine slows progression of the disease and minimizes prednisolone-induced side effects. It is important that VKH patients are treated with pathogenetic therapy in close cooperation with an immunologist. Long-term monitoring (not less than 2-3 years) is also necessary.

UI MeSH Term Description Entries
D008775 Methylprednisolone A PREDNISOLONE derivative with similar anti-inflammatory action. 6-Methylprednisolone,Medrol,Metipred,Urbason,6 Methylprednisolone
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D004305 Dose-Response Relationship, Drug The relationship between the dose of an administered drug and the response of the organism to the drug. Dose Response Relationship, Drug,Dose-Response Relationships, Drug,Drug Dose-Response Relationship,Drug Dose-Response Relationships,Relationship, Drug Dose-Response,Relationships, Drug Dose-Response
D005260 Female Females
D005938 Glucocorticoids A group of CORTICOSTEROIDS that affect carbohydrate metabolism (GLUCONEOGENESIS, liver glycogen deposition, elevation of BLOOD SUGAR), inhibit ADRENOCORTICOTROPIC HORMONE secretion, and possess pronounced anti-inflammatory activity. They also play a role in fat and protein metabolism, maintenance of arterial blood pressure, alteration of the connective tissue response to injury, reduction in the number of circulating lymphocytes, and functioning of the central nervous system. Glucocorticoid,Glucocorticoid Effect,Glucorticoid Effects,Effect, Glucocorticoid,Effects, Glucorticoid
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014607 Uveomeningoencephalitic Syndrome A syndrome characterized by bilateral granulomatous UVEITIS with IRITIS and secondary GLAUCOMA, premature ALOPECIA, symmetrical VITILIGO, poliosis circumscripta (a strand of depigmented hair), HEARING DISORDERS, and meningeal signs (neck stiffness and headache). Examination of the cerebrospinal fluid reveals a pattern consistent with MENINGITIS, ASEPTIC. (Adams et al., Principles of Neurology, 6th ed, p748; Surv Ophthalmol 1995 Jan;39(4):265-292) Uveomeningoencephalitis,Vogt-Koyanagi-Harada Syndrome,Syndrome, VKH (Vogt Koyanagi Harada),Syndrome, Vogt Koyanagi Harada,VKH (Vogt Koyanagi Harada) Syndrome,VKH Syndrome,Vogt-Koyanagi-Harada Disease,Disease, Vogt-Koyanagi-Harada,Syndrome, Uveomeningoencephalitic,Syndrome, VKH,Syndrome, Vogt-Koyanagi-Harada,Uveomeningoencephalitides,VKH Syndrome (Vogt Koyanagi Harada),Vogt Koyanagi Harada Disease,Vogt Koyanagi Harada Syndrome
D014792 Visual Acuity Clarity or sharpness of OCULAR VISION or the ability of the eye to see fine details. Visual acuity depends on the functions of RETINA, neuronal transmission, and the interpretative ability of the brain. Normal visual acuity is expressed as 20/20 indicating that one can see at 20 feet what should normally be seen at that distance. Visual acuity can also be influenced by brightness, color, and contrast. Acuities, Visual,Acuity, Visual,Visual Acuities
D018450 Disease Progression The worsening and general progression of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis. Clinical Course,Clinical Progression,Disease Exacerbation,Exacerbation, Disease,Progression, Clinical,Progression, Disease
D041623 Tomography, Optical Coherence An imaging method using LASERS that is used for mapping subsurface structure. When a reflective site in the sample is at the same optical path length (coherence) as the reference mirror, the detector observes interference fringes. OCT Tomography,Optical Coherence Tomography,Coherence Tomography, Optical,Tomography, OCT

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