Contributions
Abstract: EP1430
Type: ePoster
Abstract Category: Clinical aspects of MS - 10 Neuro-ophthalmology
Introduction: Vogt-Koyanagi-Harada (VKH) disease is a systemic illness of autoimmune origin in which T cells target melanocytes in individuals susceptible to the disease. Clinical manifestations typically include signs and symptoms relating to the eye, ear, skin and central nervous system (CNS). Acute visual manifestations of VKH include acute uveitis with bullous serous retinal detachment and optic disk hyperemia. Previous ocular penetrating trauma, eye surgery and any other ocular disease that could be confounded with VKH must be ruled out for correct diagnosis and treatment of the condition. Among these differential diagnoses are other autoimmune diseases potentially leading to visual loss, such as multiple sclerosis (MS) and neuromyelitis optica (NMO). The objective of the present study was to report on a series of 22 well-documented VKH cases from Brazil.
Methods: Detailed reports on patients diagnosed with VKH were reviewed by neurologists and ophthalmologists caring for these individuals. Data are presented descriptively.
Results: There was clear predominance of females (91%), and the median age at the initial manifestation of VKH was 34 years. All patients had severe visual manifestations of the disease and 68% of them had concomitant neurological signs and symptoms (headache, ataxia, vertigo, dysphagia, motor deficits and neuropsychiatric manifestations). Despite prompt diagnosis and treatment in all cases, three patients presented new episodes of uveitis, five patients evolved with cataracts and one with glaucoma, and two patients were left with severe permanent loss of vision. Seven patients had been referred to the neurologist with the diagnosis of “optical neuritis” by the first physician attending the case. Other diagnoses for referral to neurologists were viral meningitis, vertigo, Behcet's disease, MS and NMO.
Conclusion: Like MS and NMO, VKH is a cause of acute visual impairment mainly affecting young women. Awareness of VKH disease is of essence in neuroimmunology.
Disclosure:
Yara Dadalti Fragoso, Tarso Adoni, Ellen Yukie F. Chiovatto, Sidney Gomes, Marcus Vinicius M. Goncalves, Myung Kim, Ernane Pires Maciel, Andre Muniz, Roberto Ivo Pasquarelli Neto, Marina A. Camargo Pereira, Luciano M. Simao, Marlos Aureliano D. de Sousa and Nise Alessandra C. Sousa have no conflicts of interest to declare. This study was carried out without any financial support.
Abstract: EP1430
Type: ePoster
Abstract Category: Clinical aspects of MS - 10 Neuro-ophthalmology
Introduction: Vogt-Koyanagi-Harada (VKH) disease is a systemic illness of autoimmune origin in which T cells target melanocytes in individuals susceptible to the disease. Clinical manifestations typically include signs and symptoms relating to the eye, ear, skin and central nervous system (CNS). Acute visual manifestations of VKH include acute uveitis with bullous serous retinal detachment and optic disk hyperemia. Previous ocular penetrating trauma, eye surgery and any other ocular disease that could be confounded with VKH must be ruled out for correct diagnosis and treatment of the condition. Among these differential diagnoses are other autoimmune diseases potentially leading to visual loss, such as multiple sclerosis (MS) and neuromyelitis optica (NMO). The objective of the present study was to report on a series of 22 well-documented VKH cases from Brazil.
Methods: Detailed reports on patients diagnosed with VKH were reviewed by neurologists and ophthalmologists caring for these individuals. Data are presented descriptively.
Results: There was clear predominance of females (91%), and the median age at the initial manifestation of VKH was 34 years. All patients had severe visual manifestations of the disease and 68% of them had concomitant neurological signs and symptoms (headache, ataxia, vertigo, dysphagia, motor deficits and neuropsychiatric manifestations). Despite prompt diagnosis and treatment in all cases, three patients presented new episodes of uveitis, five patients evolved with cataracts and one with glaucoma, and two patients were left with severe permanent loss of vision. Seven patients had been referred to the neurologist with the diagnosis of “optical neuritis” by the first physician attending the case. Other diagnoses for referral to neurologists were viral meningitis, vertigo, Behcet's disease, MS and NMO.
Conclusion: Like MS and NMO, VKH is a cause of acute visual impairment mainly affecting young women. Awareness of VKH disease is of essence in neuroimmunology.
Disclosure:
Yara Dadalti Fragoso, Tarso Adoni, Ellen Yukie F. Chiovatto, Sidney Gomes, Marcus Vinicius M. Goncalves, Myung Kim, Ernane Pires Maciel, Andre Muniz, Roberto Ivo Pasquarelli Neto, Marina A. Camargo Pereira, Luciano M. Simao, Marlos Aureliano D. de Sousa and Nise Alessandra C. Sousa have no conflicts of interest to declare. This study was carried out without any financial support.