The purpose of this review is to provide a comprehensive and updated overview of the clinical features,imaging modalities,differential diagnosis,diagnostic criteria,and treatment options for Vogt-Koyanagi-Harada(VKH)s...The purpose of this review is to provide a comprehensive and updated overview of the clinical features,imaging modalities,differential diagnosis,diagnostic criteria,and treatment options for Vogt-Koyanagi-Harada(VKH)syndrome,a rare progressive inflammatory condition characterized by bilateral granulomatous panuveitis and systemic manifestations.While the clinical features and disease course of VKH syndrome are well-characterized in the literature,its diagnosis is challenging due to a broad differential that include infectious and noninfectious causes of uveitis and rare inflammatory conditions,as well as a lack of a single diagnostic finding on exam,laboratory testing,or imaging.The evolution of the diagnostic criteria for VKH syndrome reflects the growing understanding of the disease by the ophthalmic community and advancement of imaging technology.Findings on enhanced depth imaging(EDI)optical coherence tomography(OCT)and indocyanine green angiography(ICGA)help detect subtle inflammation of the choroid and were incorporated into new diagnostic criteria developed in the last few years.There is limited research on the treatment for acute VKH,but results of studies to date support the early initiation of immunomodulatory therapy(IMT)due to a high recurrence rate and progression to chronic disease in patients treated with monotherapy with high-dose systemic corticosteroids.This review will provide an indepth summary of recent literature on advanced imaging modality and IMT to guide clinicians in their management of patients with VKH syndrome.展开更多
文摘The purpose of this review is to provide a comprehensive and updated overview of the clinical features,imaging modalities,differential diagnosis,diagnostic criteria,and treatment options for Vogt-Koyanagi-Harada(VKH)syndrome,a rare progressive inflammatory condition characterized by bilateral granulomatous panuveitis and systemic manifestations.While the clinical features and disease course of VKH syndrome are well-characterized in the literature,its diagnosis is challenging due to a broad differential that include infectious and noninfectious causes of uveitis and rare inflammatory conditions,as well as a lack of a single diagnostic finding on exam,laboratory testing,or imaging.The evolution of the diagnostic criteria for VKH syndrome reflects the growing understanding of the disease by the ophthalmic community and advancement of imaging technology.Findings on enhanced depth imaging(EDI)optical coherence tomography(OCT)and indocyanine green angiography(ICGA)help detect subtle inflammation of the choroid and were incorporated into new diagnostic criteria developed in the last few years.There is limited research on the treatment for acute VKH,but results of studies to date support the early initiation of immunomodulatory therapy(IMT)due to a high recurrence rate and progression to chronic disease in patients treated with monotherapy with high-dose systemic corticosteroids.This review will provide an indepth summary of recent literature on advanced imaging modality and IMT to guide clinicians in their management of patients with VKH syndrome.
