Vogt Koyanagi Harada Syndrome: A Pandora's Box!
Published: 2022-12-08
Page: 98-106
Issue: 2022 - Volume 5 [Issue 1]
Yogya Reddy
Department of Ophthalmology, MGM Medical College, Sector 1, Kamothe, Navi Mumbai-410209, India.
Shruti Saokar *
Department of Ophthalmology, MGM Medical College, Sector 1, Kamothe, Navi Mumbai-410209, India.
Faraaz Hussain
Department of Ophthalmology, MGM Medical College, Sector 1, Kamothe, Navi Mumbai-410209, India.
Abha Shah
Department of Ophthalmology, MGM Medical College, Sector 1, Kamothe, Navi Mumbai-410209, India.
Jesmin Alex
Department of Ophthalmology, MGM Medical College, Sector 1, Kamothe, Navi Mumbai-410209, India.
*Author to whom correspondence should be addressed.
Abstract
Vogt-Koyanagi-Harada syndrome is a rare systemic granulomatous autoimmune condition that affects melanocyte-rich organs including the eyes, inner ears, meninges, skin, and hair. It causes severe bilateral, chronic granulomatous panuveitis associated with serous retinal detachments and disc oedema. The etiology of Vogt-Koyanagi-Harada syndrome is extremely variable. Here, we report 4 cases diagnosed with Vogt-Koyanagi-Harada syndrome, who presented with completely different backgrounds. The first case was a 34M who presented with a 3 months history of diminution of vision with headache and tinnitus. The second case was a 21F who presented with a 1-day history of sudden diminution of vision associated with a headache on day 2 after undergoing an emergency lower segment cesarean section. The third patient was a 30F who was a case of systemic lupus erythematosus associated with type 4 lupus nephritis. She presented with a 2-day history of diminution of vision associated with headache and tinnitus. She had an active herpes zoster infection involving the trunk at the time of presentation. The fourth case was a 30F who presented to us 7 days post-vaccination with a 5-day history of sudden diminution of vision in both eyes.
All the patients had choroiditis with exudative retinal detachment confirmed on OCT suggestive of Vogt-Koyanagi-Harada syndrome. This case series throws light on variable etiology and multisystem involvement of Vogt-Koyanagi-Harada syndrome and management criteria. Vogt-Koyanagi-Harada syndrome is an important differential diagnosis in all patients presenting with the sudden blurring of vision with the headache.
Keywords: Vogt koyanagi harada, headache, diminution of vision, retinal detachment
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References
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