Vogt-Koyanagi-Harada disease

Background: Vogt-Koyanagi-Harada disease is a bilateral panuveitis associated with exudative retinal detachment. This disease typically affects young adults, and occurs most frequently among Asians. Meningeal signs, dysacusis, poliosis and vitiligo are usual features of the condition.

Methods: We present three patients with Vogt-Koyanagi-Harada disease.

Results: All patients presented with decreased vision. Two of them had typical prodromal symptoms, with headache and meningism. Bilateral panuveitis with exudative retinal detachment and choroidal effusion developed in all patients. Fluorescein angiography demonstrated areas of pinpoint hyperfluorescence at the level of the pigment epithelium and pooling of dye in the area of exudative detachments. All patients responded well to high-dose systemic corticosteroids, with resolution of the exudative retinal detachments and improved visual acuity. Interpretation. Vogt-Koyanagi-Harada disease is a rare, but important, diagnosis in patients with bilateral uveitis. Early administration of high-dose systemic steroids is recommended for successful treatment.