Vogt–Koyanagi–Harada disease

Vogt-Koyanagi-Harada (VKH) disease is a bilateral granulomatous panuveitis associated with extraocular manifestations, including meningism, dysacusis, and tinnitus. Various depigmentation conditions, such as vitiligo, poliosis, alopecia, and sunset glow fundus, may occur in the chronic stage or the convalescent stage. Although the exact cause remains unknown, evidence suggests an autoimmune process driven by T lymphocytes against antigens in the melanocytes. Bilateral exudative retinal detachment is the most characteristic ocular finding. Fluorescein angiography, indocyanine green angiography, and optical coherence tomography are useful tools for diagnosing and for monitoring therapeutic effects. The acceptable treatment to suppress intraocular inflammation is systemic corticosteroids. Most cases can be managed successfully, but a few patients may require an additional immunomodulatory agent, such as cyclosporine. In general, VKH patients treated with optimal systemic corticosteroids have a fair visual prognosis; the exceptions are patients with recurrent inflammation.