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Precise, simplified diagnostic criteria and optimised management of initial-onset Vogt–Koyanagi–Harada disease: an updated review

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dc.contributor.authorHerbort, Carl
dc.contributor.authorTugal, Ilknur
dc.contributor.authorAbu, Ahmed
dc.contributor.authorGupta, Amod
dc.contributor.authorTakeuchi, Masaru
dc.contributor.authorFardeau, Christine
dc.contributor.authorHedayatfar, Alireza
dc.contributor.authorUrzúa, Cristhian
dc.contributor.authorPapasavvas, Ioannis
dc.date.accessioned2023-04-10T19:26:06Z
dc.date.available2023-04-10T19:26:06Z
dc.date.issued2022
dc.description.abstractVogt-Koyanagi-Harada (VKH) disease is a primary autoimmune stromal choroiditis. This review aimed to provide a novel perspective of the disease. We took into account recent developments in the understanding of the disease and crucial progress in investigational modalities of the choroid, which has led to new, simpler diagnostic criteria. We analysed recent novel notions in the literature and new diagnostic tools for VKH. We identified the following updates for VKH disease: (1) A crucial differentiation between the acute initial-onset and the chronic forms of the disease; (2) the integration of new, precise imaging methods to assess choroidal inflammation; (3) the promotion of simplified, more reliable diagnostic criteria for acute initial-onset of the disease, based on the sine qua non presence of diffuse choroiditis, detected with indocyanine green angiography (ICGA) and/or Enhanced Depth Imaging OCT (EDI-OCT); and (4) treatment optimisation through early, vigorous, sustained corticosteroid and nonsteroidal immunosuppression, as the first line of treatment for initial-onset VKH disease, and monitoring subclinical choroidal inflammation during follow-ups. Several studies have shown that most patients could discontinue treatment without an inflammation relapse. ICGA and EDI-OCT represented the methods of choice for precisely monitoring disease evolution. Simplified, precise, new diagnostic criteria allow early diagnosis of VKH. In VKH disease, inflammation exclusively originates in the choroidal stroma. Therefore, in many cases, early, sustained treatment, with dual corticosteroid and nonsteroidal immunosuppressive therapy can result in full "healing", which obviates chronic, uncontrolled, subclinical choroidal inflammation.
dc.description.versionVersión publicada
dc.identifier.citationHerbort CP Jr, Tugal-Tutkun I, Abu-El-Asrar A, Gupta A, Takeuchi M, Fardeau C, Hedayatfar A, Urzua C, Papasavvas I. Precise, simplified diagnostic criteria and optimised management of initial-onset Vogt-Koyanagi-Harada disease: an updated review. Eye (Lond). 2022 Jan;36(1):29-43. doi: 10.1038/s41433-021-01573-3
dc.identifier.doihttps://doi.org/10.1038/s41433-021-01573-3
dc.identifier.urihttps://repositorio.udd.cl/handle/11447/7289
dc.language.isoen
dc.subjectAdrenal Cortex Hormones / therapeutic use
dc.subjectChoroid
dc.subjectChoroiditis / diagnosis
dc.subjectChoroiditis / drug therapy
dc.subjectFluorescein Angiography / methods
dc.subjectInflammation / drug therapy
dc.subjectUveomeningoencephalitic Syndrome / diagnosis
dc.subjectUveomeningoencephalitic Syndrome / drug therapy
dc.titlePrecise, simplified diagnostic criteria and optimised management of initial-onset Vogt–Koyanagi–Harada disease: an updated review
dc.typeArticle
dcterms.accessRightsAcceso Abierto
dcterms.sourceEye
dspace.entity.typePublication

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