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Invited Commentary
September 2018

Improving the Diagnostic Criteria for Vogt-Koyanagi-Harada Disease

Author Affiliations
  • 1Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York
  • 2Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
  • 3Department of Epidemiology, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
JAMA Ophthalmol. 2018;136(9):1032-1033. doi:10.1001/jamaophthalmol.2018.2657

Uveitis refers to a collection of more than 30 diseases characterized by intraocular inflammation. Vogt-Koyanagi-Harada disease (VKH) is among the most common uveitic diseases in Asia. In the United States, it most often occurs among individuals with Hispanic or Native American ancestry.1 Although sometimes described as quadriphasic (with prodromal, acute uveitic, convalescent, and recurrent or chronic phases), VKH typically occurs in 2 distinct phases: early and late.1 Early VKH is characterized by exudative retinal detachments, with or without anterior chamber and vitreous inflammation, combined with neurologic symptoms and signs (eg, tinnitus, dysacusis, vertigo, meningismus, and cerebrospinal fluid pleocytosis). Late VKH is characterized by a chronic anterior uveitis or chronic panuveitis (with Dalen-Fuchs–like choroidal nodules), a characteristic retinal depigmentation (sunset glow fundus), and cutaneous changes (eg, alopecia, poliosis, and vitiligo).2