1. What is VKH?
2. What are the extraocular systemic findings of VKH?
3. What are the ocular findings of VKH?
4. What are the diagnostic criteria?
5. What is the clinical course of VKH?
6. What are the laboratory tests needed?
7. What is the therapy for VKH?
8. How do I get more information?

What is VKH?

VKH stands for Vog-Koyanagi-Harada syndrome. It is a systemic disorder involving many organ systems, including the eyes, ears, skin, and meninges.

Nussenblat R, Whitcup S, "Uveitis: Fundamentals and Clinical Practice", Third edition, Mosby-Year Book, 2004.

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What are the extraocular systemic findings of VKH?

There is a prodromal stage, wherein, the patient may complain of headache, orbital pain, stiff neck, and vertigo. Fever, facial weakness, sensorial and behavioral changes may be present. CNS, auditory and skin lesion may be part of the disease complex.

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What are the ocular findings of VKH?

The disease is usually bilateral, although one eye may be inflamed initially. The second eye usually follows within 2 weeks. Vision is decreased with light sensitivity, redness and pain. Your ophthalmologist will see signs of uveitis, scleritis, glaucoma, and other ocular inflammation.

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What are the diagnostic criteria?

American Journal of Ophthalmology 131:647-652, 2001.

The Vogt-Koyanagi-Harada's (VKH) Disease Committee established the "Revised diagnostic criteria for VKH disease" in 2001.The VKH Committee's revised diagnostic criteria proved useful for VKH disease diagnosis, as the concordance rate for the two criteria was more than 90%. However, patients who had prior cataract surgery or who lacked signs of serous retinal detachment were not classified as having VKH disease because of exclusion by the VKH Committee's new criteria.

Am J Ophthalmol. 2005 Jun;139(6):1080-5. Comparative study of two sets of criteria for the diagnosis of Vogt-Koyanagi-Harada's disease. Kitamura M, Takami K, Kitachi N, Namba K, Kitamei H, Kotake S, Ohno S. Department of Ophthalmology and Visual Sciences, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-ku, Sapporo 060-8638, Japan.

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What is the clinical course of VKH?

The clinical course of VKH is varied with some patients having a limited period of severe ocular inflammatory activity, followed by rapid depigmentation with no further episodes while other patients have continuing chronic disease.

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What are the laboratory tests needed?

1. Flourescein angiography
2. Indocyanine green angiography
3. Electroretinogram and electrooculogram
4. Lumbar puncture
5. Glucose tolerance testing
6. Blood serum testing

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What is the therapy for VKH?

The drug of choice is corticosteroid. Immunosuppresives are given for steroid resistant and chronic recurrent cases.

Corticosteroids at 2 mg/kg/day of prednisone or pulse therapy of 1 g/day methylprednisolone x 3 days followed by 1 mg/kg/day of prednisone

1. Cyclophosphamide
2. Chlorambucil 
3. Azathioprine
4. Cyclosporinel
5. FK 506

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How do I get more information?

There are several ways of reaching the ophthalmologists of EYE REPUBLIC Ophthalmology Clinic: Hover note: Please place your mouse cursor over the red box to click on the web and email links. For websites, a new browser window will open. For emails, your default email program will open. You may cut and paste the URLs or email addresses if you prefer not to open new windows. ONLINE ACCESS WEBSITES.      http://www.EyeRepublic.com.ph - EYE REPUBLIC Ophthalmology Clinic      http://www.OCP.com.ph - Ophthalmic Consultants Philippines Co. -      http://www.LASIK.com.ph - Refractive Surgery Resource      http://www.Cataract.com.ph  - Cataract Surgery Resource      http://www.Eye.com.ph - Eye Information Online      http://www.EyeDoc4Kids.com.ph - Eye Information for Kids      http://www.Retina.com.ph - Retina Surgery Resource      http://www.Glaucoma.com.ph - Glaucoma Online      http://www.Uveitis.com.ph - Uveitis Online EMAIL. After writing down your comments, suggestions, problems and/or questions, kindly tell us how to get in touch with you by providing your name, email, home/office numbers, and mobile phone.      General inquiries - help@EyeRepublic.com.ph      Refractive Surgery Service - refractive.surgery@EyeRepublic.com.ph      Glaucoma Service - glaucoma@EyeRepublic.com.ph      Cataract Service - cataract@EyeRepublic.com.ph      Doctors - eyemd@EyeRepublic.com.ph       Administrative - president@EyeRepublic.com.ph      Website - webmaster@EyeRepublic.com.ph      Newsletter - newsletter@EyeRepublic.com.ph (receive news and updates, discounts and promotions) BLOG. Send us your comments.      EYE REPUBLIC      Ophthalmology Atlas CLINIC INFORMATION      Mobile E-Yellow Pages. Via SMS, text LUK4 EYEREPUBLIC (send to 2851 for Globe and Sun Cellular, and 2951 for Smart).
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