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Vogt-Koyanagi-Harada disease: the stepby-step approach to a better understanding of clinicopathology, immunopathology, diagnosis, and management: a brief review

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dc.contributor.authorUrzĂșa, Cristhian
dc.contributor.authorHerbort, Carl
dc.contributor.authorTakeuchi, Masaru
dc.contributor.authorSchlaen, Ariel
dc.contributor.authorConcha, Luz
dc.contributor.authorUsui, Yoshihiko
dc.contributor.authorCuitino, Loreto
dc.contributor.authorPapasavvas, Ioannis
dc.date.accessioned2023-04-10T19:26:10Z
dc.date.available2023-04-10T19:26:10Z
dc.date.issued2022
dc.description.abstractBackground: Appraisals of Vogt-Koyanagi-Harada disease (VKH) have become progressively more complete, since its first description in 1906. The availability of new investigational methods has improved our knowledge of the immunopathology, clinicopathology, diagnosis, and management of VKH disease. This review aimed to describe some of the steps that led to better characterization of VKH as a clinical entity. Methods: We searched on PubMed for articles that described the history of VKH disease and analyzed the progress in disease appraisal with new investigational and imaging methods. In particular, we searched for articles that investigated the clinicopathology, diagnosis, and management of VKH. Findings: The following developments were considered essential for improving the appraisal and understanding of VKH: (1) the history of the disease, (2) immunopathological mechanisms, (3) clinicopathology, (4) the importance of distinguishing initial-onset from chronic disease, (5) relevant imaging modalities, among which indocyanine green angiography is crucial, (6) diagnostic criteria that facilitate early diagnosis, and (7) the need for early, prolonged, aggressive treatment that combines steroidal and non-steroidal immunosuppression. Conclusion: Based on these findings, the definition of VKH has improved. VKH disease starts in the choroidal stroma and later involves other structures when it is not diagnosed and treated early. Indocyanine green angiography and enhanced depth imaging optical coherence tomography facilitate early diagnosis and precise monitoring of choroidal inflammation. ICGA is clearly the gold standard for appraisals and follow-ups in VKH disease, however EDI-OCT should be especially considered in those areas where ICGA is not fully available. These modalities have contributed substantially to a "cure" for VKH, when treatment is introduced within the therapeutic window of opportunity.
dc.description.versionVersiĂłn publicada
dc.identifier.citationUrzua CA, Herbort CP Jr, Takeuchi M, Schlaen A, Concha-Del-Rio LE, Usui Y, Cuitino L, Papasavvas I. Vogt-Koyanagi-Harada disease: the step-by-step approach to a better understanding of clinicopathology, immunopathology, diagnosis, and management: a brief review. J Ophthalmic Inflamm Infect. 2022 May 12;12(1):17. doi: 10.1186/s12348-022-00293-3
dc.identifier.doihttps://doi.org/10.1186/s12348-022-00293-3
dc.identifier.urihttps://repositorio.udd.cl/handle/11447/7290
dc.language.isoen
dc.subjectChronic VKH
dc.subjectInitial-onset acute VKH
dc.subjectUveomeningoencephalitic syndrome
dc.subjectVogt-Koyanagi-Harada disease
dc.titleVogt-Koyanagi-Harada disease: the stepby-step approach to a better understanding of clinicopathology, immunopathology, diagnosis, and management: a brief review
dc.typeArticle
dcterms.accessRightsAcceso Abierto
dcterms.sourceJournal of ophthalmic inflammation and infection
dspace.entity.typePublication

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