Revised Diagnostic Criteria for Vogt-Koyanagi-Harada Disease: Considerations on the Different Disease Categories

摘要

VOGT-KOYANAGI-HARADA (VKH) DISEASE REPRE-sents 6% of uveitis examined at the Uveitis Service, Department of Ophthalmology, Hospital das Clinicas, University of Sao Paulo School of Medicine (HCFMUSP), Sao Paulo, Brazil. Along with Behcet disease, it is one of the most prevalent causes of noninfectious uveitis in Brazil. VKH disease is an autoimmune disease mediated by Th1-lymphocytes reacting against melano-cyte-related antigens such as tyrosinase and related proteins. There is a well-defined association between disease susceptibility and HLA-DRB1*0405 in several populations, including Brazilian patients. However, no single laboratory test can be assigned as a hallmark of the presence of disease. In the acute phase, most patients present with a characteristic clinical picture and ancillary examination confirms the diagnosis. Patients who come to medical attention in the chronic phase of disease may pose a diagnostic challenge as most of the acute manifestations have subsided. The diagnosis of VKH is clinical and several criteria have been proposed in the past, such as the American Uveitis Society (AUS) Criteria and Sugiura's Criteria