Vogt Koyanagi Harada Syndrome: A Pandora's Box!
Asian Journal of Research and Reports in Ophthalmology,
Page 27-35
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
Herbort CP, Mochizuki M. Vogt-Koyanagi-Harada disease: Inquiry into the genesis of a disease name in the historical context of Switzerland and Japan. Int Ophthalmol. 2007;27(2-3):67-79.
Greco A, Fusconi M, Gallo A, et al. Vogt-Koyanagi-Harada syndrome. Autoimmun Rev. 2013;12(11):1033-8.
DOI:10.1016/j.autrev.2013.01.004
Reddy Y, Pandey A, Ojha A, Ramchandani S. Harada-like syndrome post-Covishield vaccination: A rare adverse effect. Indian Journal of Ophthalmology. 2022; 70(1):321.
Burkholder, Bryn M. Vogt−Koyanagi−Harada disease, Current Opinion in Ophthalmology. 2015;26(6): 506-511.
Tian-Wei Qian et al. Int. J Ophthalmol. 2018;11(8):1430-1432.
Nohara M and Norose, Kazumi and Segawa K. Vogt-Koyanagi-Harada disease during pregnancy. The British Journal of Ophthalmology. 1995;79:94-5.
DOI: 10.1136/bjo.79.1.94
Miyata N, Sugita M, Nakamura S, et al. Treatment of Vogt-Koyanagi-Harada's disease during pregnancy. JPN. J Ophthalmol. 2001;45(2):177-80.
DOI: 10.1016/s0021-5155(00)00357-9.
Chen D, Li H, Xie J, Zhan Z, Liang L, Yang X. Herpes zoster in patients with systemic lupus erythematosus: Clinical features, complications and risk factors. Exp Ther Med. 2017;14(6):6222-6228.
DOI: 10.3892/etm.2017.5297.
Epub 2017 Oct 12.
PMID: 29285180;
PMCID: PMC5740583.
Campos WR, Cenachi SPF, Soares MS, et al. Vogt-Koyanagi-Harada-like disease following yellow fever vaccination. Ocul Immunol Inflamm. 2021;29(1):124-7.
Sood AB, O'Keefe G, Bui D, Jain N. Vogt-Koyanagi-Harada Disease Associated with Hepatitis B Vaccination. Ocul Immunol Inflamm. 2019;27(4):524-527.
Crosson JN, Laird PW, Debiec M, et al. Vogt-Koyanagi-Harada-like syndrome after CTLA-4 inhibition with ipilimumab for metastatic melanoma. J Immunother. 2015;38(2):80-4.
Patel SU, Khurram R, Lakhani A, Quirk B. Guillain-Barre syndrome following the first dose of the chimpanzee adenovirus-vectored COVID-19 vaccine, ChAdOx1. BMJ Case Rep. 2021;14(4):e242956.
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