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Ikuno Y, Yamaguchi A, Takahashi T, Fujimoto N. Vogt-Koyanagi-Harada Syndrome Following COVID-19 mRNA Vaccination: Th2 to Th1 Transition-related Molecular Machinery. Acta Derm Venereol 2024; 104:adv21502. [PMID: 38738771 PMCID: PMC11107829 DOI: 10.2340/actadv.v104.21502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 01/16/2024] [Indexed: 05/14/2024] Open
Abstract
Abstract is missing (Short communication)
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Affiliation(s)
- Yasuaki Ikuno
- Department of Dermatology, Shiga University of Medical Science, Setatsukinowa, Otsu, Shiga, Japan
| | - Akihiko Yamaguchi
- Department of Dermatology, Shiga University of Medical Science, Setatsukinowa, Otsu, Shiga, Japan.
| | - Toshifumi Takahashi
- Department of Dermatology, Shiga University of Medical Science, Setatsukinowa, Otsu, Shiga, Japan
| | - Noriki Fujimoto
- Department of Dermatology, Shiga University of Medical Science, Setatsukinowa, Otsu, Shiga, Japan
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2
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Fauquier A, Barba T, Hot A, Sève P, Elbany S, Blanche P, Monnet D, Brézin A, Terrier B, Durel CA. Impact of Initial Management on Disease Evolution in Vogt-Koyanagi-Harada Syndrome: A Retrospective Cohort of 50 Patients. Ocul Immunol Inflamm 2024; 32:402-406. [PMID: 37141529 DOI: 10.1080/09273948.2023.2206485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 04/20/2023] [Indexed: 05/06/2023]
Abstract
PURPOSE The study aims to determine the impact of initial management in Vogt-Koyanagi-Harada syndrome (VKHS). METHODS Patients diagnosed with a VKHS between January 2001 and December 2020 in two French tertiary centers were included in a retrospective study. RESULTS Fifty patients were included with a median duration of follow-up of 29.8 months. All patients received oral prednisone after methylprednisolone in all but four of them. Five patients received at least one associated immunosuppressive therapy (IST) within the first 6 months and 26 patients received IST during the entire follow-up period. Twenty-eight patients presented at least one relapse at a median of 5.4 months from diagnosis. Multivariate analyses demonstrated a significant association between relapse and delayed treatment (>26 days) (HR = 3.69, CI95% 1.30-10.47, p = .01), whereas no association was observed between relapse and the number of corticosteroid pulses at initial management. CONCLUSION An early corticosteroid treatment within the first 26 days of symptoms decreased the relapse rate.
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Affiliation(s)
- Alice Fauquier
- Department of Internal Medicine, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Thomas Barba
- Department of Internal Medicine, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Arnaud Hot
- Department of Internal Medicine, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Pascal Sève
- Department of Internal Medicine, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Sandra Elbany
- Department of Ophthalmology, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Philippe Blanche
- Department of Internal Medicine, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université de Paris Cité, Paris, France
| | - Dominique Monnet
- Department of Ophthalmology, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université de Paris Cité, Paris, France
| | - Antoine Brézin
- Department of Ophthalmology, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université de Paris Cité, Paris, France
| | - Benjamin Terrier
- Department of Internal Medicine, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université de Paris Cité, Paris, France
| | - Cécile-Audrey Durel
- Department of Internal Medicine, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
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Kesav NP, Kim S, Chiang TK, Matta M, Honda K, Kurup SK. Tattoo-Induced Exacerbations of Systemic Disease and Uveitis. JOURNAL OF VITREORETINAL DISEASES 2024; 8:339-342. [PMID: 38770085 PMCID: PMC11102725 DOI: 10.1177/24741264241233384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Purpose: To examine an underreported and underdiagnosed phenomenon with implications for the pathophysiological mechanisms of tattoo-induced uveitis. Methods: Two cases highlighting the clinical presentation of tattoo-related uveitis were evaluated. Results: A 28-year-old man with biopsy-proven sarcoidosis and ocular manifestations presented with worsening retinal vasculitis after acquiring a red-ink tattoo. Each subsequent flare followed acquisition of a new tattoo. A 31-year-old woman without systemic sarcoidosis presented with multiple episodes of bilateral intermediate uveitis and macular edema concurrent with inflammatory granulomas to recently acquired black-ink tattoos. A skin biopsy in both patients showed cutaneous noncaseating granulomas. Conclusions: These cases add to those reported in the literature and emphasize the importance of understanding the modifiable factors of inflammatory ocular disease. Future study is necessary to understand the mechanisms of tattoo-related uveitis.
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Affiliation(s)
- Natasha P. Kesav
- Department of Ophthalmology and Visual Sciences, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Suzie Kim
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic, Cleveland, OH, USA
| | - Tsun-Kang Chiang
- Department of Ophthalmology and Visual Sciences, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Maroun Matta
- Department of Pulmonary, University Hospitals Cleveland Medical Center, Critical Care and Sleep Medicine, Cleveland, OH, USA
| | - Kord Honda
- Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Shree K. Kurup
- Department of Ophthalmology and Visual Sciences, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
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Souto FMS, Missaka RFBG, Lavezzo MM, Nóbrega PFC, Sakata VM, Oyamada MK, Hirata CE, Yamamoto JH. Quality of Life (QoL) in Non-Acute Vogt-Koyanagi-Harada Disease (VKHD) at Two Time Points 24 Months Apart. Ocul Immunol Inflamm 2024; 32:384-390. [PMID: 36637906 DOI: 10.1080/09273948.2022.2152697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 12/01/2022] [Accepted: 11/11/2022] [Indexed: 01/14/2023]
Abstract
AIMS To investigate the changes in quality-of-life (QoL) metrics at a 24-month interval in non-acute VKHD patients and their association with inflammation, treatment, and visual function. METHODS SF-36 and VFQ-25 questionnaires were administered at two 24-month-apart moments to 22 non-acute VKHD patients followed for ≥12 months since acute disease onset. "Improvement," "unchanged," or "worsening" in questionnaires scores (difference >5-point) between M1 and M2 and their associations were sought. RESULTS Absence of systemic treatment or optic disc hyperfluorescence was associated with improved general health (SF-36). Improvement in binocular contrast sensitivity resulted in better ocular pain score; absence of anterior uveitis relapse, stable fundus findings, no use of cyclosporine or no intravitreal injections resulted in unchanged/better dependency score; no intravitreal injections resulted in unchanged/better mental health score (VFQ-25). CONCLUSION Stability/improvement in QoL scores was associated with controlled inflammation, better visual function, and no need for treatment. Subclinical inflammatory signs did not impact QoL scores.
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Affiliation(s)
| | | | - Marcelo Mendes Lavezzo
- Department of Ophthalmology, LIM-33, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | | | | | - Maria Kiyoko Oyamada
- Department of Ophthalmology, LIM-33, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Carlos Eduardo Hirata
- Department of Ophthalmology, LIM-33, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Joyce Hisae Yamamoto
- Department of Ophthalmology, LIM-33, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
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Li H, Li Z, Mao A, Dong P, Wang W. A case report: co-occurrence of probable Vogt-Koyanagi-Harada disease and diabetic retinopathy. BMC Ophthalmol 2024; 24:148. [PMID: 38566041 PMCID: PMC10985950 DOI: 10.1186/s12886-024-03410-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 03/24/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Bilateral retinal detachment and choroidal detachment in a patient are rare occurrences. The presence of bilateral diabetic retinopathy (DR) in such a case is even rarer and complicates the condition. CASE PRESENTATION In this study, we document a case of unconventional VKH. Manifestations in this patient included intense peripheral retinal detachment and choroidal detachment, along with vitreous opacities akin to cotton wool spots, concurrent with DR. The diagnosis was considered as probable VKH with DR. Treatment according to VKH protocols, including high-dose corticosteroids, yielded positive results. CONCLUSIONS VKH can co-occurrence with DR. VKH manifestations vary, and early, aggressive, and long-term treatment is essential. The complexity of treatment increases with concurrent DR, necessitating the use of immunosuppressants.
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Affiliation(s)
- Huan Li
- Hebei Provincial Key Laboratory of Ophthalmology, Hebei Provincial Clinical Research Center for Eye Diseases, Hebei Eye Hospital, No.399, Quanbei East Street, 54000, Xingtai, Hebei Province, China
| | - Zhiyong Li
- Hebei Provincial Key Laboratory of Ophthalmology, Hebei Provincial Clinical Research Center for Eye Diseases, Hebei Eye Hospital, No.399, Quanbei East Street, 54000, Xingtai, Hebei Province, China
| | - Ailing Mao
- Hebei Provincial Key Laboratory of Ophthalmology, Hebei Provincial Clinical Research Center for Eye Diseases, Hebei Eye Hospital, No.399, Quanbei East Street, 54000, Xingtai, Hebei Province, China
| | - Ping Dong
- Hebei Provincial Key Laboratory of Ophthalmology, Hebei Provincial Clinical Research Center for Eye Diseases, Hebei Eye Hospital, No.399, Quanbei East Street, 54000, Xingtai, Hebei Province, China
| | - Wei Wang
- Hebei Provincial Key Laboratory of Ophthalmology, Hebei Provincial Clinical Research Center for Eye Diseases, Hebei Eye Hospital, No.399, Quanbei East Street, 54000, Xingtai, Hebei Province, China.
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Tayal A, Daigavane S, Gupta N. Vogt-Koyanagi-Harada Disease: A Narrative Review. Cureus 2024; 16:e58867. [PMID: 38800227 PMCID: PMC11116741 DOI: 10.7759/cureus.58867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 04/23/2024] [Indexed: 05/29/2024] Open
Abstract
Vogt-Koyanagi-Harada (VKH) disease is an idiopathic immune-related sickness that affects multiple systems and melanocytes in organs such as the uvea, ear, and meninges. The primary cause of activity is cellular immunological responses. Vogt-Koyanagi disease is identified primarily by skin abnormalities and anterior uveitis. Harada's illness is distinguished by neurological symptoms and exudative retinal detachments, which are associated with the HLA-DR4 and HLA-DRw53 genes. Pigmented races, such as Hispanics and Native Americans, are more likely to have VKH disease. Clinical features are blurred vision, floaters, alopecia, vitiligo, diffuse choroidal inflammation with disc edema, and exudative retinal detachment. Differential diagnoses include posterior scleritis, uveal effusion syndrome, central serous chorioretinopathy, and sympathetic ophthalmitis. The investigations used are optical coherence tomography (OCT), fundus fluorescein angiography (FA), and B-scan ultrasonography (USG). Treatment is done by using systemic steroids, cycloplegics, and immunosuppressants.
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Affiliation(s)
- Ayushi Tayal
- Department of Ophthalmology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sachin Daigavane
- Department of Ophthalmology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Nivesh Gupta
- Department of Ophthalmology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Koyama M, Nishijima E, Honda T, Gonmori-Ohta C, Sasamoto T, Tanaka K, Watanabe A, Nakano T, Akiyama M. Vogt-Koyanagi-Harada disease developed during chemotherapy for Hodgkin lymphoma: a case report. BMC Ophthalmol 2024; 24:115. [PMID: 38481205 PMCID: PMC10935796 DOI: 10.1186/s12886-024-03386-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 03/07/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Ocular manifestations are known for non-Hodgkin lymphoma, but are rare for Hodgkin lymphoma. We report a case of Vogt-Koyanagi-Harada (VKH) disease presenting as serous retinal detachment and uveitis in both eyes in a child undergoing chemotherapy for Hodgkin lymphoma. CASE PRESENTATION The patient was a 7-year-old boy with stage IIB Hodgkin lymphoma (nodular lymphocyte predominant type) who was undergoing chemotherapy, including 2 cycles of the OEPA regimen and 1 cycle of the COPDAC regimen. Two days after the end of the COPDAC regimen, the patient complained of headache and of blurred and decreased vision in both eyes. On the basis of optic symptoms, such as uveitis and serous retinal detachment in both eyes, increased cell counts in cerebrospinal fluid, and positivity for human leukocyte antigen (HLA)-DR4 in peripheral blood cells, incomplete VKH disease was diagnosed. Intravenous treatment with high-dose prednisolone (60mg/m2/day) for 7 days improved both visual acuity and serous retinal detachment and enabled the remains of the COPDAC chemotherapy cycle to be administered. With prednisolone treatment, visual acuity improved from 20/500 to 20/20 in the right eye and from 20/63 to 20/25 in the left eye. Because multiple vitiligo lesions later appeared in the abdomen, complete VKH disease was finally diagnosed. CONCLUSION The onset of VKH disease occurred during chemotherapy for Hodgkin lymphoma. The patient was HLA-DR4-positive and might have had a predisposition to develop autoimmune diseases, including VKH disease. However, the anticancer drugs administered to this patient have not been reported to cause uveitis. Whether Hodgkin lymphoma triggered the development of VKH remains unclear. Early diagnosis of VKH disease and prompt treatment with high-dose prednisone enabled the patient to maintain good visual function despite chemotherapy for Hodgkin lymphoma.
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Affiliation(s)
- Mutsumi Koyama
- Department of Ophthalmology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, 105-8561, Tokyo, Japan
| | - Euido Nishijima
- Department of Ophthalmology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, 105-8561, Tokyo, Japan
| | - Takaya Honda
- Department of Pediatrics, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, 105-8461, Tokyo, Japan
| | - Chizuru Gonmori-Ohta
- Department of Pediatrics, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, 105-8461, Tokyo, Japan
| | - Takeaki Sasamoto
- Department of Pediatrics, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, 105-8461, Tokyo, Japan
| | - Katsuyuki Tanaka
- Department of Pediatrics, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, 105-8461, Tokyo, Japan
| | - Akira Watanabe
- Department of Ophthalmology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, 105-8561, Tokyo, Japan
| | - Tadashi Nakano
- Department of Ophthalmology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, 105-8561, Tokyo, Japan
| | - Masaharu Akiyama
- Department of Pediatrics, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, 105-8461, Tokyo, Japan.
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Ravindran RS, Aswin PR, Abdul Khadar SM. One-minute ophthalmology: "To PI or not to PI". Indian J Ophthalmol 2024; 72:311. [PMID: 38421289 PMCID: PMC11001221 DOI: 10.4103/ijo.ijo_811_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
Affiliation(s)
| | - PR Aswin
- Department of Retina and Vitreous, Aravind Eye Hospital, Tirunelveli, Tamil Nadu, India
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Fernández-Navarro J, García-García J, Gregorio García-García J, Segura T. Ultrasonographic study of the orbit as an early diagnostic tool in Vogt Koyanagi Harada disease (VKH): A case report. Heliyon 2024; 10:e26196. [PMID: 38379990 PMCID: PMC10877363 DOI: 10.1016/j.heliyon.2024.e26196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 02/05/2024] [Accepted: 02/08/2024] [Indexed: 02/22/2024] Open
Abstract
In recent years, ultrasound has demonstrated its usefulness in the approach to vascular structures and other tissues such as the orbit, facilitating the early diagnosis of various diseases without having to rely on other more invasive or less available tests. In Vogt Koyanagi Harada syndrome, characterised by bilateral acute uveitis, ocular ultrasound is a clear example of the usefulness of ultrasonography in early diagnosis, facilitating the initiation of specific treatment to change the ominous natural history of this disease. This case shows the usefulness of the echography to make the differential diagnosis with other diseases that clinical onset could be similar than VKH, but with a different diagnostic and therapeutic approach.
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Affiliation(s)
- José Fernández-Navarro
- Department of Neurology, Puerta del Mar Universitary Hospital, av/Ana de Viya 21, 11009 Cádiz, Spain
| | - Jorge García-García
- Department of Neurology, Complejo Hospitalario Universitario de Albacete, c/Hermanos Falco 37, 02006 Albacete, Spain
| | - José Gregorio García-García
- Department of Ophthalmology, Complejo Hospitalario Universitario de Albacete, c/Hermanos Falco 37, 02006 Albacete, Spain
| | - Tomás Segura
- Department of Neurology, Complejo Hospitalario Universitario de Albacete, c/Hermanos Falco 37, 02006 Albacete, Spain
- Instituto de Investigación en Discapacidades Neurológicas (IDINE), Facultad de Medicina, Universidad de Castilla-La Mancha, 02008 Albacete, Spain
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Zhang H, Houadj L, Wu KY, Tran SD. Diagnosing and Managing Uveitis Associated with Immune Checkpoint Inhibitors: A Review. Diagnostics (Basel) 2024; 14:336. [PMID: 38337852 PMCID: PMC10855398 DOI: 10.3390/diagnostics14030336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 01/29/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
This review aims to provide an understanding of the diagnostic and therapeutic challenges of uveitis associated with immune checkpoint inhibitors (ICI). In the wake of these molecules being increasingly employed as a treatment against different cancers, cases of uveitis post-ICI therapy have also been increasingly reported in the literature, warranting an extensive exploration of the clinical presentations, risk factors, and pathophysiological mechanisms of ICI-induced uveitis. This review further provides an understanding of the association between ICIs and uveitis, and assesses the efficacy of current diagnostic tools, underscoring the need for advanced techniques to enable early detection and accurate assessment. Further, it investigates the therapeutic strategies for ICI-related uveitis, weighing the benefits and limitations of existing treatment regimens, and discussing current challenges and emerging therapies in the context of their potential efficacy and side effects. Through an overview of the short-term and long-term outcomes, this article suggests recommendations and emphasizes the importance of multidisciplinary collaboration between ophthalmologists and oncologists. Finally, the review highlights promising avenues for future research and development in the field, potentially informing transformative approaches in the ocular assessment of patients under immunotherapy and the management of uveitis following ICI therapy.
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Affiliation(s)
- Huixin Zhang
- Faculty of Medicine, Laval University, Quebec, QC G1V 0A6, Canada;
| | - Lysa Houadj
- Faculty of Medicine, University of Sherbrooke, Sherbrooke, QC J1G 2E8, Canada;
| | - Kevin Y. Wu
- Department of Surgery, Division of Ophthalmology, University of Sherbrooke, Sherbrooke, QC J1G 2E8, Canada
| | - Simon D. Tran
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC H3A 1G1, Canada
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11
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Ejaz K, Yaseen K. The skin, the eyes, and the ears in Vogt-Koyanagi-Harada disease (VKHD). Clin Rheumatol 2024; 43:817-818. [PMID: 37864644 DOI: 10.1007/s10067-023-06795-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/09/2023] [Accepted: 10/12/2023] [Indexed: 10/23/2023]
Affiliation(s)
- Komal Ejaz
- Department of Rheumatic and Immunologic Diseases, Cleveland Clinic, 9500 Euclid Avenue/A50, Cleveland, OH, 44195, USA.
| | - Kinanah Yaseen
- Department of Rheumatic and Immunologic Diseases, Center for Vasculitis Care and Research, Cleveland Clinic, 9500 Euclid Avenue/A50, Cleveland, OH, 44195, USA
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12
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Al Hashmi S, Al Habsi N, Al Abrawi S. Vogt-Koyanagi-Harada Syndrome (VKHS): First Two Cases Reported in Pediatric Age Group in Oman. Case Rep Pediatr 2023; 2023:1745603. [PMID: 37928616 PMCID: PMC10622593 DOI: 10.1155/2023/1745603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 09/24/2023] [Accepted: 09/28/2023] [Indexed: 11/07/2023] Open
Abstract
The Vogt-Koyanagi-Harada syndrome (VKHS) is a unique form of granulomatous autoimmune disease that mostly impacts the pigmented tissues of the body. The main feature is bilateral granulomatous panuveitis, which is detected on ophthalmologic examination, along with additional systemic signs such as vitiligo, white hair, neurological involvement, or hearing loss. This study aims to report two cases of Vogt-Koyanagi-Harada syndrome presented in the children age group, which is unusual and very rare, to improve recognition of this disease to avoid complications and delay referral.
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Affiliation(s)
- Samiya Al Hashmi
- Department of Child Health, Pediatric Rheumatology Unit, Royal Hospital, Muscat, Oman
| | - Nasra Al Habsi
- Department of Ophthalmology, Ophthalmology Unit, Al Nahdah Hospital, Muscat, Oman
| | - Safiya Al Abrawi
- Department of Child Health, Pediatric Rheumatology Unit, Royal Hospital, Muscat, Oman
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13
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Zou Y, Kamoi K, Zong Y, Zhang J, Yang M, Ohno-Matsui K. Ocular Inflammation Post-Vaccination. Vaccines (Basel) 2023; 11:1626. [PMID: 37897028 PMCID: PMC10611055 DOI: 10.3390/vaccines11101626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 10/29/2023] Open
Abstract
The association between vaccines and ocular disorders has attracted significant attention in scientific research. Numerous mainstream vaccines are associated with a range of uveitis types, including anterior, intermediate, and posterior uveitis. Additionally, they are associated with distinct ocular diseases such as multifocal choroiditis, Vogt-Koyanagi-Harada (VKH) disease, acute posterior multifocal placoid pigment epitheliopathy (APMPPE), and multiple evanescent white dot syndrome (MEWDS). These ocular conditions are often transient, with a vast majority of patients experiencing improvement after steroid intervention. To date, numerous cases of vaccine-induced uveitis have been reported. This study analyzed the correlation between antiviral vaccines, including the hepatitis B virus (HBV), human papillomavirus (HPV), measles-mumps-rubella (MMR), varicella zoster virus (VZV), and influenza vaccines, and different manifestations of uveitis. This is the first comprehensive study to offer a detailed analysis of uveitis types induced by antiviral vaccines. Through an extensive database search, we found a particularly strong link between influenza vaccines, followed by VZV and HPV vaccines. While anterior uveitis is common, conditions such as APMPPE, MEWDS, and VKH are particularly notable and merit careful consideration in clinical practice. Corticosteroid treatment was effective; however, half of the observed patients did not achieve full recovery, indicating potentially prolonged effects of the vaccine.
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Affiliation(s)
| | - Koju Kamoi
- Department of Ophthalmology & Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan; (Y.Z.); (Y.Z.); (J.Z.); (M.Y.); (K.O.-M.)
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14
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Lee MA, Hulsebosch SE, Affolter VK, Dear JD, Knipe MF, Maggs DJ, Moore BA, Outerbridge CA, Marsilio S. Polyautoimmunity manifest as inflammatory myopathy, uveitis, and progressive cutaneous depigmentation in a mixed breed dog: a case report. BMC Vet Res 2023; 19:198. [PMID: 37817164 PMCID: PMC10563350 DOI: 10.1186/s12917-023-03764-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 09/30/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Polyautoimmunity is the expression of more than one autoimmune disease in a single patient. This report documents polyautoimmunity in a mixed breed dog with concurrent uveitis, cutaneous depigmentation, and inflammatory myopathy. CASE PRESENTATION A 1-year-old male neutered mixed breed dog was presented for progressive generalized leukotrichia and leukoderma, bilateral panuveitis, and masticatory muscle atrophy. The latter progressed to myositis of lingual, pharyngeal, and masticatory muscles confirmed by biopsy. Temporalis muscle was completely replaced by adipose and fibrous tissue, and necrotic myofibers with extensive infiltration of mononuclear cells indicated active myositis of lingual muscle. Skin biopsies showed severe melanin clumping in epidermis, hair follicles, and hair shafts, and perifollicular pigmentary incontinence. Uveitis, depigmentation, and myositis affecting the masticatory, pharyngeal, and tongue muscles were diagnosed based on clinical, histological, and laboratory findings. CONCLUSIONS To the authors' knowledge, this is the first report of concurrent uveitis, progressive cutaneous depigmentation, and inflammatory myopathy in a dog.
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Affiliation(s)
- Mary Ann Lee
- School of Veterinary Medicine, University of California, Davis, Davis, CA, USA
| | - Sean E Hulsebosch
- Department of Medicine and Epidemiology, University of California, Davis, 1 Garrod Drive, Davis, CA, 95616, USA
| | - Verena K Affolter
- Department of Pathology, Microbiology and Immunology, University of California, Davis, Davis, CA, USA
| | - Jonathan D Dear
- Department of Medicine and Epidemiology, University of California, Davis, 1 Garrod Drive, Davis, CA, 95616, USA
| | - Marguerite F Knipe
- Department of Surgical and Radiological Sciences, University of California, Davis, Davis, CA, USA
| | - David J Maggs
- Department of Surgical and Radiological Sciences, University of California, Davis, Davis, CA, USA
| | - Bret A Moore
- Department of Small Animal Clinical Sciences, University of Florida, Gainesville, FL, USA
| | - Catherine A Outerbridge
- Department of Medicine and Epidemiology, University of California, Davis, 1 Garrod Drive, Davis, CA, 95616, USA
| | - Sina Marsilio
- Department of Medicine and Epidemiology, University of California, Davis, 1 Garrod Drive, Davis, CA, 95616, USA.
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15
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Kaya P, İnanç Tekin M, Özdal PÇ. Predictive Factors for the Prognosis of Vogt-Koyanagi-Harada Disease. Ocul Immunol Inflamm 2023; 31:1687-1693. [PMID: 36628436 DOI: 10.1080/09273948.2022.2159841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 12/13/2022] [Indexed: 01/12/2023]
Abstract
PURPOSE To identify the prognostic factors in Vogt-Koyanagi-Harada (VKH) disease. METHODS This study included 23 patients (46 eyes) with acute-phase VKHdivided into two subgroups: Group 1; acute-resolved (10 patients), group 2; chronic-recurrent (13 patients). RESULTS Mean age were 29.5 ± 10.2 years in group 1, 35.8 ± 12.2 years group 2 (p = .033). Best-corrected visual acuity with logMAR at admission was 0.91 ± 0.65 in group 1, 0.88 ± 0.62 in group 2 (p = .798), and improved to 0.08 ± 0.24, 0.18 ± 0.6, respectively (p = .557). Extraocular findings were detected in 30% in group 1, and 53.8% in group 2 at the time of admission (p = .108). All patients were treated with 1 g/day 3-5 days intravenous steroid, and 10 patients had immunomodulatory treatment. Initiation of immunomodulatory therapy did not affect the prognosis (p = .676). CONCLUSION Older patients and/or who developed extraocular findings at the presentation were more prone to show recurrences.
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Affiliation(s)
- Pınar Kaya
- Department of Opthalmology, University of Health Science, Ulucanlar Eye Education and Research Hospital, Ankara, Turkey
| | - Merve İnanç Tekin
- Department of Opthalmology, University of Health Science, Ulucanlar Eye Education and Research Hospital, Ankara, Turkey
| | - Pınar Çakar Özdal
- Department of Opthalmology, University of Health Science, Ulucanlar Eye Education and Research Hospital, Ankara, Turkey
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Manni P, Saturno MC, Accorinti M. Vogt-Koyanagi-Harada Disease and COVID. J Clin Med 2023; 12:6242. [PMID: 37834885 PMCID: PMC10573236 DOI: 10.3390/jcm12196242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 08/26/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023] Open
Abstract
Vogt-Koyanagi-Harada (VKH) is a rare multisystem inflammatory disease affecting the eyes, ears, brain, skin, and hair. The Coronavirus Disease 2019 (COVID-19) is a new contagious infection that might trigger the onset of VKH disease, as previously proposed for other viruses. Moreover, after the mass vaccination against SARS-CoV-2 worldwide, cases of VKH disease associated with COVID-19 vaccination have been reported. We present an overview of VKH and a comprehensive literature revision of all the VKH cases described after COVID-19 infection and vaccination, adding our experience. No differences have been found considering epidemiology and clinical findings of the disease compared to those reported in the no-COVID era. All of the patients promptly responded to systemic and local corticosteroid therapy with a good final visual prognosis. Different possible pathogenetic mechanisms underlying the onset of VKH after COVID-19 vaccination are discussed, while the presence of the HLA DR4 antigen as a genetic predisposition for the onset of the disease after COVID-19 infection and vaccination is proposed. VKH disease is one of the most frequently reported uveitic entities after COVID-19 vaccination, but a good response to therapy should not discourage vaccination. Nevertheless, ophthalmologists should be alerted to the possibility of VKH occurrence or relapse after COVID-19 vaccination, especially in genetically predisposed subjects.
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Affiliation(s)
| | | | - Massimo Accorinti
- Ocular Immunovirology Service, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; (P.M.); (M.C.S.)
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Kang H, Sun H, Yang Y, Tuong ZK, Shu M, Wei Y, Zhang Y, Yu D, Tao Y. Autoimmune uveitis in Behçet's disease and Vogt-Koyanagi-Harada disease differ in tissue immune infiltration and T cell clonality. Clin Transl Immunology 2023; 12:e1461. [PMID: 37720629 PMCID: PMC10503407 DOI: 10.1002/cti2.1461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 06/16/2023] [Accepted: 08/04/2023] [Indexed: 09/19/2023] Open
Abstract
Objectives Non-infectious uveitis is often secondary to systemic autoimmune diseases, with Behçet's disease (BD) and Vogt-Koyanagi-Harada disease (VKHD) as the two most common causes. Uveitis in BD and VKHD can show similar clinical manifestations, but the underlying immunopathogenesis remains unclear. Methods To understand immune landscapes in inflammatory eye tissues, we performed single-cell RNA paired with T cell receptor (TCR) sequencing of immune cell infiltrates in aqueous humour from six patients with BD (N = 3) and VKHD (N = 3) uveitis patients. Results Although T cells strongly infiltrated in both types of autoimmune uveitis, myeloid cells only significantly presented in BD uveitis but not in VKHD uveitis. Conversely, VKHD uveitis but not BD uveitis showed an overwhelming dominance by CD4+ T cells (> 80%) within the T cell population due to expansion of CD4+ T cell clusters with effector memory (Tem) phenotypes. Correspondingly, VKHD uveitis demonstrated a selective expansion of CD4+ T cell clones which were enriched in pro-inflammatory Granzyme H+ CD4+ Tem cluster and showed TCR and Th1 pathway activation. In contrast, BD uveitis showed a preferential expansion of CD8+ T cell clones in pro-inflammatory Granzyme H+ CD8+ Tem cluster, and pathway activation for cytoskeleton remodelling, cellular adhesion and cytotoxicity. Conclusion Single-cell analyses of ocular tissues reveal distinct landscapes of immune cell infiltration and T-cell clonal expansions between VKHD and BD uveitis. Preferential involvements of pro-inflammatory CD4+ Th1 cells in VKHD and cytotoxic CD8+ T cells in BD suggest a difference in disease immunopathogenesis and can guide precision disease management.
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Affiliation(s)
- Hao Kang
- Department of Ophthalmology, Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina
| | - Hongjian Sun
- Frazer Institute, Faculty of MedicineThe University of QueenslandBrisbaneQLDAustralia
- Shandong Artificial Intelligence InstituteQilu University of Technology (Shandong Academy of Sciences)JinanChina
| | - Yang Yang
- Frazer Institute, Faculty of MedicineThe University of QueenslandBrisbaneQLDAustralia
- Shandong Artificial Intelligence InstituteQilu University of Technology (Shandong Academy of Sciences)JinanChina
| | - Zewen K Tuong
- Ian Frazer Centre for Children's Immunotherapy Research, Children's Health Research Centre, Faculty of MedicineThe University of QueenslandBrisbaneQLDAustralia
| | - Minglei Shu
- Shandong Artificial Intelligence InstituteQilu University of Technology (Shandong Academy of Sciences)JinanChina
| | - Yunbo Wei
- School of Pharmaceutical Sciences, Laboratory of Immunology for Environment and Health, Shandong Analysis and Test CenterQilu University of Technology (Shandong Academy of Sciences)JinanChina
| | - Yu Zhang
- School of Pharmaceutical Sciences, Laboratory of Immunology for Environment and Health, Shandong Analysis and Test CenterQilu University of Technology (Shandong Academy of Sciences)JinanChina
| | - Di Yu
- Frazer Institute, Faculty of MedicineThe University of QueenslandBrisbaneQLDAustralia
- Ian Frazer Centre for Children's Immunotherapy Research, Children's Health Research Centre, Faculty of MedicineThe University of QueenslandBrisbaneQLDAustralia
| | - Yong Tao
- Department of Ophthalmology, Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina
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Hosseini SM, Gharouni A, Motamed Shariati M. Vogt-Koyanagi-Harada disease with a unilateral presentation in a patient with marijuana overuse: Role of multimodal imaging in suspected patients. Clin Case Rep 2023; 11:e7879. [PMID: 37675413 PMCID: PMC10477722 DOI: 10.1002/ccr3.7879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/20/2023] [Accepted: 08/26/2023] [Indexed: 09/08/2023] Open
Abstract
Key Clinical Message Harada disease could uniquely present with only unilateral symptoms, as was seen in our patient. However, multimodal imaging including ICG angiography could show bilateral involvement. Considering the immunomodulatory effects of Cannabis, the absence of inflammatory findings and the unusual presentation of the disease, in our case, may have been caused by the use of marijuana. Abstract To report a patient addicted to marijuana with the diagnosis of Vogt-Koyanagi-Harada (VKH) disease with a unilateral presentation. A 24-year-old man presented to us with painless decreased vision in his right eye (RE) and photophobia 3 days ago. No history of significant family or past medical history was documented. Spectral-domain optical coherence tomography (SD-OCT) of the RE showed multiple areas of subretinal fluid in the macula. Indocyanine green angiography (ICGA) revealed round hypocyanescent dark dots (HDD) of similar size, evenly distributed in both eyes. With the diagnosis of VKH disease, anti-inflammatory treatment was started. To our knowledge, this is the first reported case of suspected VKH in a patient with marijuana overuse. Regarding the complex effects of tetrahydrocannabinol (THC), the active ingredient of marijuana, on the vascular and immune systems, reaching a definite conclusion is not possible. This report shows the value of multimodal imaging in patients with unusual presentations.
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Affiliation(s)
| | - Ahmad Gharouni
- Eye Research Center, Mashhad University of Medical SciencesMashhadIran
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19
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Madoe A, Schauwvlieghe PP, Jacob J. VOGT-KOYANAGI-HARADA DISEASE-LIKE UVEITIS IN A PATIENT WITH ADVANCED MELANOMA TREATED BY SEQUENTIAL ADMINISTRATION OF NIVOLUMAB AND DABRAFENIB/TRAMETINIB THERAPY. Retin Cases Brief Rep 2023; 17:611-615. [PMID: 37643052 DOI: 10.1097/icb.0000000000001251] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
PURPOSE To describe a case of bilateral Vogt-Koyanagi-Harada (VKH)-like uveitis during treatment with dabrafenib and trametinib and three months after discontinuation of nivolumab for malignant melanoma, and discuss the possible (synergistic) role(s) of mitogen-activated protein kinase (MAPK) inhibitors and immune checkpoint inhibitors in its pathophysiology. METHODS Retrospective case report with fluorescein angiography and optical coherence tomography. RESULTS A 55-year old patient with metastatic melanoma presented with a complaint of gradually worsening blurry vision in the right eye during treatment with dabrafenib and trametinib, three months after discontinuation of nivolumab. Based on the clinical examination, optical coherence tomography and fluorescein angiography findings, and a thorough laboratory work-up, he was diagnosed with a bilateral VKH-like uveitis without extraocular manifestations. The uveitis responded well to oral corticosteroids. CONCLUSION Vogt-Koyanagi-Harada-like uveitis is a rare adverse effect of MAPK inhibitors and immune checkpoint inhibitors. Similar pathogenetic mechanisms including a drug-induced autoimmunity targeted against benign and malignant melanocytes may underlie MAPK inhibitor-induced and immune checkpoint inhibitors-induced VKH-like uveitis. In our report, the patient developed a VKH-like uveitis during MAPK inhibition therapy, four months after discontinuation of nivolumab. It is difficult to delineate whether MAPK inhibition alone was responsible for this adverse effect, or whether, on the contrary, potentiation occurred as a result of immune modulation by previous treatment with an immune checkpoint inhibitor. Further cases are needed to further clarify this latter hypothesis.
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Affiliation(s)
- Aline Madoe
- Department of Ophthalmology, University Hospital of Leuven, Leuven, Belgium
| | - Pieter-Paul Schauwvlieghe
- Department of Ophthalmology, University Hospital of Leuven/Middelheim Hospital in Antwerp, Leuven, Belgium; and
| | - Julie Jacob
- Department of Ophthalmology, University Hospital of Leuven, Leuven, Belgium
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Wei J, Mu J, Tang Y, Qin D, Duan J, Wu A. Next-generation nanomaterials: advancing ocular anti-inflammatory drug therapy. J Nanobiotechnology 2023; 21:282. [PMID: 37598148 PMCID: PMC10440041 DOI: 10.1186/s12951-023-01974-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 06/29/2023] [Indexed: 08/21/2023] Open
Abstract
Ophthalmic inflammatory diseases, including conjunctivitis, keratitis, uveitis, scleritis, and related conditions, pose considerable challenges to effective management and treatment. This review article investigates the potential of advanced nanomaterials in revolutionizing ocular anti-inflammatory drug interventions. By conducting an exhaustive analysis of recent advancements and assessing the potential benefits and limitations, this review aims to identify promising avenues for future research and clinical applications. The review commences with a detailed exploration of various nanomaterial categories, such as liposomes, dendrimers, nanoparticles (NPs), and hydrogels, emphasizing their unique properties and capabilities for accurate drug delivery. Subsequently, we explore the etiology and pathophysiology of ophthalmic inflammatory disorders, highlighting the urgent necessity for innovative therapeutic strategies and examining recent preclinical and clinical investigations employing nanomaterial-based drug delivery systems. We discuss the advantages of these cutting-edge systems, such as biocompatibility, bioavailability, controlled release, and targeted delivery, alongside potential challenges, which encompass immunogenicity, toxicity, and regulatory hurdles. Furthermore, we emphasize the significance of interdisciplinary collaborations among material scientists, pharmacologists, and clinicians in expediting the translation of these breakthroughs from laboratory environments to clinical practice. In summary, this review accentuates the remarkable potential of advanced nanomaterials in redefining ocular anti-inflammatory drug therapy. We fervently support continued research and development in this rapidly evolving field to overcome existing barriers and improve patient outcomes for ophthalmic inflammatory disorders.
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Affiliation(s)
- Jing Wei
- School of Ophthalmology, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Jinyu Mu
- School of Ophthalmology, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Yong Tang
- Sichuan Key Medical Laboratory of New Drug Discovery and Druggability Evaluation, Education Ministry Key Laboratory of Medical Electrophysiology, School of Pharmacy, Southwest Medical University, Luzhou, 646000, China
| | - Dalian Qin
- Sichuan Key Medical Laboratory of New Drug Discovery and Druggability Evaluation, Education Ministry Key Laboratory of Medical Electrophysiology, School of Pharmacy, Southwest Medical University, Luzhou, 646000, China
| | - Junguo Duan
- School of Ophthalmology, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China.
| | - Anguo Wu
- Sichuan Key Medical Laboratory of New Drug Discovery and Druggability Evaluation, Education Ministry Key Laboratory of Medical Electrophysiology, School of Pharmacy, Southwest Medical University, Luzhou, 646000, China.
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Lim YJ, Byon I, Kim HW, Park SW, Kwon HJ, Kim E. Incidence and Risk Factors of Recurrent Anterior Uveitis in Initial Acute-Onset Vogt-Koyanagi-Harada Disease. KOREAN JOURNAL OF OPHTHALMOLOGY 2023; 37:299-306. [PMID: 37400085 PMCID: PMC10427900 DOI: 10.3341/kjo.2023.0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/25/2023] [Accepted: 06/23/2023] [Indexed: 07/05/2023] Open
Abstract
PURPOSE We report the estimated incidence of, and risk factors for, recurrent anterior uveitis in patients with initial acute-onset Vogt-Koyanagi-Harada (VKH) disease using survival analyses. METHODS Patients who were diagnosed with initial acute-onset VKH disease during 2003-2022 at two university hospitals were included. Recurrent anterior uveitis was defined as the first occurrence of the granulomatous anterior uveitis with anterior chamber cells and flare of 2+ or more by the Standardization of Uveitis Nomenclature (SUN) Working Group grading scheme, after the disappearance of conspicuous uveitis and serous retinal detachment for at least 3 months, regardless of systemic or local treatment. The univariate log-rank test and multivariate Cox regression analyses were performed, including patients' demographic characteristics, underlying diseases, presence of prodromal symptoms, duration of visual symptoms, visual acuity, slit-lamp and fundus findings, and height of serous retinal detachment. The treatment method and response to treatment were also included. RESULTS The estimated incidence was 39.3% at 10 years. Fifteen of 55 patients (27.3%) had recurrent anterior uveitis during the mean follow-up of 4.5 years. The presence of focal posterior synechiae at the diagnosis increased the risk of recurrent anterior uveitis 6.97-fold compared to the absence of synechiae (95% confidence interval [CI], 2.20-22.11; p < 0.001). Use of systemic high-dose steroid therapy more than 7 days after the development of visual symptoms resulted in a hazard ratio of 4.55 (95% CI, 1.27-16.40; p = 0.020). CONCLUSIONS This study reports the estimated incidence and risk factors of recurrent anterior uveitis in VKH disease from survival analyses. However, because of the retrospective nature of this study, it is hard to confirm the consistency of the medical records regarding risk factors, thus, the presence of focal posterior synechiae can be inconclusive as a risk factor. Further studies are warranted.
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Affiliation(s)
- Yeon Ju Lim
- Department of Ophthalmology, Inje University Haeundae Paik Hospital, College of Medicine, Inje University, Busan,
Korea
| | - Iksoo Byon
- Department of Ophthalmology, Pusan National University Hospital, Pusan National University School of Medicine, Busan,
Korea
| | - Hyun Woong Kim
- Department of Ophthalmology, Inje University Haeundae Paik Hospital, College of Medicine, Inje University, Busan,
Korea
| | - Sung Who Park
- Department of Ophthalmology, Pusan National University Hospital, Pusan National University School of Medicine, Busan,
Korea
| | - Han Jo Kwon
- Department of Ophthalmology, Pusan National University Hospital, Pusan National University School of Medicine, Busan,
Korea
| | - EunAh Kim
- Department of Ophthalmology, Inje University Haeundae Paik Hospital, College of Medicine, Inje University, Busan,
Korea
- Department of Ophthalmology, Pusan National University Hospital, Pusan National University School of Medicine, Busan,
Korea
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Xu K, Gao B, Li J, Xiang Y, Cao L, Zhao M. Clinical features, diagnosis, and management of COVID-19 vaccine-associated Vogt-Koyanagi-Harada disease. Hum Vaccin Immunother 2023; 19:2220630. [PMID: 37282614 PMCID: PMC10305503 DOI: 10.1080/21645515.2023.2220630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 05/18/2023] [Accepted: 05/30/2023] [Indexed: 06/08/2023] Open
Abstract
Vogt-Koyanagi-Harada (VKH) disease is a rare and serious ocular adverse reaction following COVID-19 vaccination. This study aimed to evaluate the clinical features, diagnosis and management of COVID-19 vaccine-associated VKH disease. Case reports of VKH disease after COVID-19 vaccination were collected up to February 11, 2023 for retrospective analysis. Twenty-one patients (9 males and 12 females) were included, with a median age of 45 years (range 19-78), from three main regions, Asia (12/21), the Mediterranean region (4/21), and South America (5/21). Fourteen patients developed symptoms after the first dose of the vaccine, and 8 after the second dose. Vaccines included mRNA vaccine (10 cases), virus vector vaccine (6 cases), and inactivated vaccine (5 cases). The average time interval from vaccination to onset of symptoms was 7.5 days (range 12 hours to 4 weeks). All 21 patients experienced visual impairment after vaccination, with 20 cases involving both eyes. Sixteen patients showed symptoms of meningitis. Serous retinal detachment was observed in 16 patients, choroidal thickening was observed in 14, aqueous cell in 9, and subretinal fluid in 6. CSF pleocytosis was detected in 7 patients and skin symptoms were found in 3 patients. All patients received corticosteroid therapy, and 8 also received immunosuppressive agents. All patients recovered well, with a mean recovery time of 2 months. Early diagnosis and early treatment are crucial to the prognosis of patients with VKH after vaccination with COVID-19 vaccine. The risk of vaccination against COVID-19 in patients with a history of VKH disease should be evaluated clinically.
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Affiliation(s)
- Ke Xu
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
- Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Bingqian Gao
- Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Jiayi Li
- Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Yixin Xiang
- Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Lin Cao
- Academician Workstation, Changsha Medical University, Changsha, China
- Hunan Provincial Key Laboratory of the Research and Development of Novel Pharmaceutical Preparations, Changsha Medical University, Changsha, China
| | - Mingyi Zhao
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
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Engin CD, Kayabasi M, Koksaldi S, Ipek SC, Saatci AO. Does Subretinal Fluid Optical Density Ratio Differ Among the Eyes with Acute Central Serous Chorioretinopathy,Vogt Koyanagi Harada Disease and Choroidal Hemangioma: A Cross-sectional Study. Photodiagnosis Photodyn Ther 2023:103634. [PMID: 37244453 DOI: 10.1016/j.pdpdt.2023.103634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/08/2023] [Accepted: 05/23/2023] [Indexed: 05/29/2023]
Abstract
PURPOSE To investigate the diagnostic value of optical density ratio (ODR) in various diseases with subretinal fluid (SRF) due to different pathophysiologies. METHODS Patients with acute central serous chorioretinopathy; CSCR (n=49), Vogt Koyanagi Harada disease; VKH (n=34), and choroidal hemangioma (n=17) characterized with SRF were included. Spectral-domain optical coherence tomography (SD-OCT) images were analyzed using ImageJ by three independent readers. The ODRs were calculated using "region of interest (ROI)" and "entire region (TOTAL)" selection methods from the SRF to the vitreous, retinal nerve fiber layer (RNFL), and retinal pigment epithelium (RPE) reflectivity ratios. A correlation analysis between age, central macular thickness (CMT), SRF height, SRF width, and ODRs were obtained. RESULTS Optical density (OD) measurement was highly reproducible (intraclass correlation coefficient> 0.9). Optical density of the SRF, vitreous, RNFL, and signal strength were comparable (p=0.360, p=0.247, p=0.105, and 0.628, respectively). There was no difference in SRF OD measurements between the two methods (p=0.401), while there was a significant difference in vitreous OD measurements (p=0.016). ANOVA test of ODR(ROI), ODR(TOTAL), ODR-RPE (ROI) and ODR-RNFL (ROI) revealed no significant difference among acute CSCR, VKH disease and choroidal hemangioma groups (p>0.05 for all). Correlation analysis revealed a significant negative correlation between SRF height (p < 0.05) and CMT (p < 0.01) with SRF ODR(ROI). CONCLUSION ODR measurement appears to be a highly repeatable SD-OCT parameter for diseases characterized with SRF collection. Despite variations in their pathophysiology, the ODR was not statistically different in acute CSCR, VKH disease, and choroidal hemangioma.
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Affiliation(s)
- Ceren Durmaz Engin
- Department of Ophthalmology, Buca Seyfi Demirsoy Education and Research Hospital, Izmir 35390, Turkey.
| | - Mustafa Kayabasi
- Department of Ophthalmology, Dokuz Eylul University, Izmir 35330, Turkey
| | - Seher Koksaldi
- Department of Ophthalmology, Dokuz Eylul University, Izmir 35330, Turkey
| | - Sefik Can Ipek
- Department of Ophthalmology, Bodrum Goz Akademi Hospital, Mugla 48400, Turkey
| | - Ali Osman Saatci
- Department of Ophthalmology, Dokuz Eylul University, Izmir 35330, Turkey
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Wu Q, Zhong Z, Zhou C, Cao Q, Su G, Yang P. Association of ZC3HAV1 single nucleotide polymorphisms with the susceptibility of Vogt-Koyanagi-Harada Disease. BMC Med Genomics 2023; 16:113. [PMID: 37221558 DOI: 10.1186/s12920-023-01546-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 05/14/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Polymorphisms of genes related to the immune response have been reported to confer susceptibility to Vogt-Koyanagi-Harada (VKH) disease. This study was carried out to determine whether zinc finger CCCH-type containing antiviral 1 (ZC3HAV1) and tripartite motif-containing protein 25 (TRIM25) genetic polymorphisms are associated with this disease. METHODS A total of 766 VKH patients and 909 healthy individuals were enrolled in this two-stage case-control study. Thirty-one tag single nucleotide polymorphisms (SNPs) of ZC3HAV1 and TRIM25 were genotyped by MassARRAY System and iPLEX Gold Genotyping Assay. Allele and genotype frequencies were analyzed by the χ2 test or Fisher's exact test. Cochran-Mantel-Haenszel test was used to assess the pooled odds ratio (OR) in the combined study. A stratified analysis was performed in terms of the major clinical features of VKH disease. RESULTS We found a statistically significant increased frequency of the minor A allele of ZC3HAV1 rs7779972 (P = 1.50 × 10- 4, pooled OR = 1.332, 95%CI = 1.149-1.545) in VKH disease as compared with controls by using the Cochran-Mantel-Haenszel test. The GG genotype of rs7779972 showed a protective association with VKH disease (P = 1.88 × 10- 3, OR = 0.733, 95%CI = 0.602-0.892). There was no difference regarding the frequency of the remaining SNPs between VKH cases and controls (all P > 2.08 × 10- 3). The stratified analysis showed no significant association of rs7779972 with the major clinical characteristics of VKH disease. CONCLUSION Our study indicated that the ZC3HAV1 variant rs7779972 might confer susceptibility to VKH disease in Han Chinese.
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Affiliation(s)
- Qiuying Wu
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Zhenyu Zhong
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Chunya Zhou
- Department of Ophthalmology & Optometry, The School of Medical Technology and Engineering, Fujian Medical University, Fuzhou, P. R. China
| | - Qingfeng Cao
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Guannan Su
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Peizeng Yang
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, China.
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Zhang W, Chen Z, Yi K, Su G, Liu Y, Deng Y, Zhang Y, Cao Q, Pu Y, Luo X, Lai Y, Yang P. TET2-mediated upregulation of 5-hydroxymethylcytosine in LRRC39 promoter promotes Th1 responses in association with downregulated Treg response in Vogt-Koyanagi-Harada disease. Clin Immunol 2023; 250:109323. [PMID: 37019422 DOI: 10.1016/j.clim.2023.109323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 03/31/2023] [Indexed: 04/05/2023]
Abstract
DNA 5-Hydroxymethylcytosine (5-hmC), an oxidative reaction mediated by the ten-eleven translocation (TET) family, has been reported to play an essential role in the progression of auto-inflammatory and autoimmune diseases. By far, little is known about the effect of DNA 5-hmC and the TET family on the development of Vogt-Koyanagi-Harada (VKH) disease. In this study, we discovered that the global DNA 5-hmC level and the TET activity were elevated in association with the up-regulated expression of TET2 at both mRNA and protein levels in CD4+T cells from active VKH patients compared to healthy controls. Integrated analysis of DNA 5-hmC pattern and transcription profile of CD4+ T cells revealed that 6 candidate target genes were involved in the development of VKH disease. The promoter 5-hmC and mRNA levels of leucine rich repeat containing 39 (LRRC39) were verified to be elevated in active VKH patients. Functional experiments showed that TET2 could up-regulate LRRC39 mRNA expression by increasing the promoter 5-hmC level of LRRC39 in CD4+ T cells from active VKH patients. Up-regulated LRRC39 expression could increase the frequencies of IFN-γ+ and IL-17+ CD4+ T cells as well as the secretions of IFN-γ and IL-17 in association with the decreased frequency of CD4+CD25+FOXP3+ regulatory T (Treg) cells and the reduced production of IL-10. Additionally, restoration of LRRC39 rescued TET2-silencing-mediated reduced frequency of IFN-γ+ CD4+ T cells and increased frequency of CD4+CD25+FOXP3+ Treg cells. Collectively, our study reveals a novel axis, TET2-5-hmC-LRRC39-Th1/Treg responses axis, in the pathogenesis of VKH and provides a potential target for further investigation into the epigenetic therapy of this disease.
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Affiliation(s)
- Wanyun Zhang
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, People's Republic of China
| | - Zhijun Chen
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, People's Republic of China
| | - Kun Yi
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, People's Republic of China
| | - Guannan Su
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, People's Republic of China
| | - Yaning Liu
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, People's Republic of China
| | - Yang Deng
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, People's Republic of China
| | - Yinan Zhang
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Henan Province Eye Hospital, Henan International Joint Research Laboratory for Ocular Immunology and Retinal Injury Repair, Zhengzhou, People's Republic of China; The Academy of Medical Sciences, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Qingfeng Cao
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, People's Republic of China
| | - Yanlin Pu
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, People's Republic of China
| | - Xiang Luo
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, People's Republic of China
| | - Yujie Lai
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, People's Republic of China
| | - Peizeng Yang
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, People's Republic of China.
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Divar M, Tadayyon S, Khoshneviszadeh M, Pirhadi S, Attarroshan M, Mobaraki K, Damghani T, Mirfazli S, Edraki N. Benzyl‐Triazole Derivatives of Hydrazinecarbothiamide Derivatives as Potent Tyrosinase Inhibitors: Synthesis, Biological Evaluation, Structure‐Activity Relationship and Docking Study. ChemistrySelect 2023. [DOI: 10.1002/slct.202203382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Affiliation(s)
- Masoumeh Divar
- Medicinal and Natural Products Chemistry Research Center Shiraz University of Medical Sciences 7134853734 Shiraz Iran
| | - Somayeh Tadayyon
- Medicinal and Natural Products Chemistry Research Center Shiraz University of Medical Sciences 7134853734 Shiraz Iran
- Department of Medicinal Chemistry School of Pharmacy Shiraz University of Medical Sciences 7146864685 Shiraz Iran
| | - Mehdi Khoshneviszadeh
- Medicinal and Natural Products Chemistry Research Center Shiraz University of Medical Sciences 7134853734 Shiraz Iran
- Department of Medicinal Chemistry School of Pharmacy Shiraz University of Medical Sciences 7146864685 Shiraz Iran
| | - Somayeh Pirhadi
- Medicinal and Natural Products Chemistry Research Center Shiraz University of Medical Sciences 7134853734 Shiraz Iran
| | - Mahshid Attarroshan
- Medicinal and Natural Products Chemistry Research Center Shiraz University of Medical Sciences 7134853734 Shiraz Iran
| | - Kourosh Mobaraki
- Medicinal and Natural Products Chemistry Research Center Shiraz University of Medical Sciences 7134853734 Shiraz Iran
- Department of Medicinal Chemistry School of Pharmacy Shiraz University of Medical Sciences 7146864685 Shiraz Iran
| | - Tahereh Damghani
- Medicinal and Natural Products Chemistry Research Center Shiraz University of Medical Sciences 7134853734 Shiraz Iran
| | - Sara Mirfazli
- Department of Medicinal Chemistry School of Pharmacy Iran University of Medical Sciences 1475886671 Tehran Iran
| | - Najmeh Edraki
- Medicinal and Natural Products Chemistry Research Center Shiraz University of Medical Sciences 7134853734 Shiraz Iran
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Amaral C, Rodriguez E, Barquet V, Fantauzzi A, De Jesus Rodriguez E, Ulloa-Padilla JP, Pappaterra-Rodriguez M, Requejo GA, Vila MS, Figueroa R, Fernandez CJ, Almodovar JC, Santos C, Oliver AL. Seasonal Patterns of Vogt-Koyanagi-Harada Disease. Ocul Immunol Inflamm 2023; 31:362-366. [PMID: 35133938 DOI: 10.1080/09273948.2022.2029499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To identify the relationship between the incidence of Vogt-Koyanagi-Harada (VKH) disease and seasonality. METHODS A retrospective cohort study was performed, including patients with a confirmed diagnosis of VKH whose month of disease onset was available. Information on patients was entered retrospectively into a database and analyzed according to the month and season. RESULTS Twenty-four patients who met the inclusion criteria were included in the analysis. There was a statistically significant deviation from expected values in the incidences of VKH per season (P = .043). The most common season for the onset of VKH was fall, with 50% of the patients presenting in this season, while spring was the least common season for VKH presentation, with 12.5% of the patients presenting in this season. CONCLUSION Our study suggests that the onset of VKH in Puerto Rico follows a seasonal pattern, with most cases occurring during the fall.
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Affiliation(s)
- Claudia Amaral
- Department of Ophthalmology, University of Puerto Rico, San Juan, Puerto Rico, USA
| | - Eduardo Rodriguez
- Department of Ophthalmology, University of Puerto Rico, San Juan, Puerto Rico, USA
| | - Viviana Barquet
- Department of Ophthalmology, University of Puerto Rico, San Juan, Puerto Rico, USA.,Department of Ophthalmology, Cook County Health, Chicago, Illinois, USA
| | - Andres Fantauzzi
- Department of Ophthalmology, University of Puerto Rico, San Juan, Puerto Rico, USA
| | | | - Jan P Ulloa-Padilla
- Department of Ophthalmology, University of Puerto Rico, San Juan, Puerto Rico, USA
| | | | - Guillermo A Requejo
- Department of Ophthalmology, University of Puerto Rico, San Juan, Puerto Rico, USA
| | - Mariam S Vila
- Department of Ophthalmology, University of Puerto Rico, San Juan, Puerto Rico, USA.,Bascom Palmer Eye Institute, Bascom Palmer Eye Institute, Miami, Florida, USA
| | - Raul Figueroa
- Department of Ophthalmology, University of Puerto Rico, San Juan, Puerto Rico, USA
| | - Carlos J Fernandez
- Department of Ophthalmology, University of Puerto Rico, San Juan, Puerto Rico, USA
| | - Juan C Almodovar
- Department of Ophthalmology, University of Puerto Rico, San Juan, Puerto Rico, USA
| | - Carmen Santos
- Department of Ophthalmology, University of Puerto Rico, San Juan, Puerto Rico, USA
| | - Armando L Oliver
- Department of Ophthalmology, University of Puerto Rico, San Juan, Puerto Rico, USA
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Zhang M, Zhang X. T cells in ocular autoimmune uveitis: Pathways and therapeutic approaches. Int Immunopharmacol 2023; 114:109565. [PMID: 36535124 DOI: 10.1016/j.intimp.2022.109565] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/29/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022]
Abstract
Autoimmune uveitis is a non-infectious intraocular condition that affects the uveal tract of the eye and threatens vision if not treated properly. Increasing evidence suggests that activated CD4+ T cells are associated with progressive and permanent destruction of photoreceptors in ocular autoimmune diseases. As such, the purpose of this review is to offer an overview of the role of CD4+ T cells in autoimmune uveitis as well as a justification for the current development and assessment of innovative autoimmune uveitis medications targeting CD4+ T cells. With an emphasis on T helper (Th)17, Th1, and Th2 cells, follicular helper CD4+ T cells, and regulatory T cells, this review presents a summary of recent research related to the pathways and signaling that encourage CD4+ T cells to develop into specialized effector cells. We also describe immunotherapeutic approaches based on CD4+ T cell subsets and their potential as therapeutic agents for autoimmune disorders.
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Affiliation(s)
- Mi Zhang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Xiaomin Zhang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.
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Clinical Comparative Study of Different Fundus Imaging Methods in the Acute Phase of Vogt-Koyanagi-Harada Disease. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:5812090. [PMID: 36262163 PMCID: PMC9576379 DOI: 10.1155/2022/5812090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 09/20/2022] [Indexed: 11/05/2022]
Abstract
Background The diversification of follow-up ophthalmic imaging examination methods, and whether there are differences in clinical characteristics of VKH at the acute stage under different images. Our study aims to compare the imaging characteristics of the acute phase of Vogt-Koyanagi-Harada disease (VKH) under different fundus imaging methods to deepen clinical knowledge. Methods A retrospective case study was performed on fundus images of 62 eyes from 31 patients with acute phase VKH and a disease duration ≤2 months who were treated at Ganzhou People's Hospital from January 2013 to December 2020. Fundus photography (FP), optical coherence tomography (OCT), and fundus fluorescein angiography (FFA) were performed on all 62 eyes. The fundus presentations were divided into an optic disc swelling (ODS) group, a serous retinal detachment (SRD) group, and a mixed type (MT) group (both ODS and SRD), and the proportions of patients in these groups and the coincidence rate of ODS, SRD, and MT identified by the three fundus imaging modes were determined. Results The proportion of patients with ODS was highest under FP, and the proportion of patients with MT was highest under OCT. The proportions of patients with ODS and MT in the three fundus imaging modes differed significantly (P < 0.05), while the proportion of patients with SRD did not (P > 0.05). The proportion of patients with subretinal fluid with positive OCT results was significantly higher than those with positive FFA results (81.08% vs. 59.46%) (P < 0.05). Conclusion Clinically significant positive signs could be obtained for acute VKH under different imaging methods. However, compared with FP and FFA, OCT tomography is more intuitive for the observation of lesions.
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Li Y, Su G, Huang F, Zhu Y, Luo X, Kijlstra A, Yang P. Identification of differently expressed mRNAs by peripheral blood mononuclear cells in Vogt-Koyanagi-Harada disease. Genes Dis 2022; 9:1378-1388. [PMID: 35873021 PMCID: PMC9293694 DOI: 10.1016/j.gendis.2021.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 06/03/2021] [Accepted: 06/05/2021] [Indexed: 11/29/2022] Open
Abstract
Vogt-Koyanagi-Harada disease (VKH) is a rare autoimmune disease characterized by diffuse and bilateral uveitis, alopecia, tinnitus, hearing loss, vitiligo and headache. The transcriptional expression pattern of peripheral blood mononuclear cells (PBMC) in VKH remains largely unknown. In this study, mRNA sequencing was conducted in PBMC from VKH patients with active uveitis before treatment (n = 7), the same patients after prednisone combined with cyclosporine treatment (n = 7) and healthy control subjects strictly matched with gender and age (n = 7). We found 118 differentially expressed genes (DEGs) between VKH patients and healthy control subjects, and 21 DEGs between VKH patients before and after treatment. TRIB1 was selected as a potential biomarker to monitor the development of VKH according to the mRNA sequencing. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis were performed to predict the possible biological functions and signaling pathways of DEGs. Neutrophil degranulation, peptidase regulator activity, secretory granule membrane, cellular response to peptide, growth factor binding and cell projection membrane were enriched as GO annotations of DEGs. Arachidonic acid metabolism and mitogen-activated protein kinase (MAPK) signaling pathway were potential signaling pathways involved in pathogenesis and drug response of VKH. A protein–protein interaction (PPI) network was constructed by STRING, and colony stimulating factor 1 receptor (CSF1R) was identified as the hubgene of all DEGs by Cytoscape. The cell type presumed to contribute to the aberrant expression of DEGs was analyzed with the use of publicly available single-cell sequencing data of PBMC from a healthy donor and single-cell sequencing dataset of monocytes from VKH patients. Our findings may help to decipher the underlying cellular and molecular pathogenesis of VKH and may lead novel therapeutic applications.
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Affiliation(s)
- Yujing Li
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Lab of Ophthalmology, Chongqing Eye Institute, Chongqing 400016, PR China
| | - Guannan Su
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Lab of Ophthalmology, Chongqing Eye Institute, Chongqing 400016, PR China
| | - Fanfan Huang
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Lab of Ophthalmology, Chongqing Eye Institute, Chongqing 400016, PR China
| | - Ying Zhu
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Lab of Ophthalmology, Chongqing Eye Institute, Chongqing 400016, PR China
| | - Xiang Luo
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Lab of Ophthalmology, Chongqing Eye Institute, Chongqing 400016, PR China
| | - Aize Kijlstra
- University Eye Clinic Maastricht, Maastricht 6211, the Netherlands
| | - Peizeng Yang
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Lab of Ophthalmology, Chongqing Eye Institute, Chongqing 400016, PR China
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31
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Pham AT, Onghanseng N, Halim MS, Ormaechea MS, Hassan M, Akhavanrezayat A, Uludag G, Tran ANT, Razeen MM, Sredar N, Dubra A, Nguyen QD. Reflectance adaptive optics findings in a patient with Vogt-Koyanagi-Harada disease. Am J Ophthalmol Case Rep 2022; 27:101660. [PMID: 35880207 PMCID: PMC9307596 DOI: 10.1016/j.ajoc.2022.101660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 05/25/2022] [Accepted: 07/10/2022] [Indexed: 11/22/2022] Open
Abstract
Purpose To describe the reflectance adaptive optics scanning laser ophthalmoscopy (AOSLO) findings in different stages of Vogt-Koyanagi-Harada (VKH) disease and correlate them to visual gain post treatment. Confocal (cAOSLO) and non-confocal split-detector AOSLO (sdAOSLO) were used to assess longitudinally the status of the photoreceptors in a patient with VKH managed on corticosteroid and immunomodulatory therapy. Observation A 32-year-old Japanese American female presented with a 2-week history of blurred vision in both eyes (OU) and worsening headache previously diagnosed as a case of VKH and treated with high dose oral prednisone. At the time of presentation, though vision was improving, and frank serous retinal detachments were absent, spectral domain optical coherence tomography (SD-OCT) showed presence of residual subretinal fluid with disruption of the photoreceptor inner segments and outer segments (IS/OS) involving OU. The photoreceptor mosaic at the foveal center appeared very sparse with large areas devoid of visible photoreceptors on cAOSLO, in agreement with the SD-OCT data. sdAOSLO imaging over the same location shows a higher number of contiguous photoreceptors. After imaging, the patient was started on mycophenolate mofetil as steroid-sparing long-term therapy. Three months later, visual acuity improved to 20/20 OU, and SD-OCT showed almost complete resolution of subretinal fluid with significant improvement of the IS/OS SD-OCT signal, OU. cAOSLO imaging revealed a contiguous photoreceptor mosaic without gaps and of normal appearance. Conclusions and Importance VKH patients may demonstrate transient photoreceptor abnormalities on SD-OCT and cAOSLO imaging. sdAOSLO imaging revealed intact photoreceptor segments in areas that appeared as voids on cAOSLO, which later showed structural recovery on SD-OCT and cAOSLO. Therefore, sdAOSLO may predict potential for improvement in patients wherein there appears to be photoreceptor loss in cAOSLO and/or SD-OCT.
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Boutros C, Peres E, Routier E, Robert C, Le Pajolec C. Severe ototoxicity associated with immune checkpoint inhibitors (ICI) in advanced melanoma. Eur J Cancer 2022; 173:204-206. [DOI: 10.1016/j.ejca.2022.06.049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 06/23/2022] [Indexed: 11/26/2022]
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Fram B, Fernandez A, Syed H, Brar V. Recurrent Vogt-Koyanagi-Harada disease presenting with diffuse orbital inflammation. Am J Ophthalmol Case Rep 2022; 27:101625. [PMID: 35761879 PMCID: PMC9233211 DOI: 10.1016/j.ajoc.2022.101625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/31/2022] [Accepted: 06/14/2022] [Indexed: 11/15/2022] Open
Affiliation(s)
- Brandon Fram
- Department of Ophthalmology, Virginia Commonwealth University Health System, Richmond, VA, USA
| | - Andrew Fernandez
- Department of Ophthalmology, Virginia Commonwealth University Health System, Richmond, VA, USA
| | - Huzaefah Syed
- Department of Rheumatology, Virginia Commonwealth University Health System, Richmond, VA, USA
| | - Vikram Brar
- Department of Ophthalmology, Virginia Commonwealth University Health System, Richmond, VA, USA
- Corresponding author. 401 N 11th St Suite 439, Richmond, VA, 23298, USA.
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Ocular Inflammation Induced by Immune Checkpoint Inhibitors. J Clin Med 2022; 11:jcm11174993. [PMID: 36078923 PMCID: PMC9456546 DOI: 10.3390/jcm11174993] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 11/16/2022] Open
Abstract
Ocular immunotherapy-related adverse events (IRAEs), although rare, can be sight-threatening. Our objective was to analyze ocular IRAEs diagnosed in France from the marketing of immune checkpoint inhibitors (ICPIs) until June 2021 and to review the literature. We collected the cases of 28 patients (36 ocular IRAEs), occurring after an average of 17 weeks (±19). Forty-six percent of patients were treated for metastatic melanoma. Anti-PD1 agents were responsible for 57% of the IRAEs. Anterior uveitis was the most common (44%), followed by panuveitis (28%). Of 25 uveitis cases, 80% were bilateral and 60% were granulomatous. We found one case with complete Vogt-Koyanagi–Harada syndrome and one case of birdshot retinochoroidopathy. The other IRAEs were eight ocular surface disorders, one optic neuropathy, and one inflammatory orbitopathy. Seventy percent of the IRAEs were grade 3 according to the common terminology of AEs. ICPIs were discontinued in 60% of patients and 50% received local corticosteroids alone. The literature review included 230 uveitis cases, of which 7% were granulomatous. The distributions of ICPIs, cancer, and type of uveitis were similar to our cohort. Ocular IRAEs appeared to be easily controlled by local or systemic corticosteroids and did not require routine discontinuation of ICPIs. Further work is still warranted to define the optimal management of ocular IRAEs.
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Kim YH, Togloom A, Oh J. Correlation Between Hyperreflective Foci in the Choroid and Choroidal Discoloration in Vogt-Koyanagi-Harada Disease. Invest Ophthalmol Vis Sci 2022; 63:27. [PMID: 36006654 PMCID: PMC9428358 DOI: 10.1167/iovs.63.9.27] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To investigate the distribution of hyperreflective choroidal foci (HCF) in eyes with Vogt-Koyanagi-Harada (VKH) disease. Methods We included 22 eyes of 11 patients with VKH disease in the convalescent stages and 22 eyes of age- and sex-matched normal controls. HCF were quantified using en face optical coherence tomography (OCT) images of the choroid, and the degree of fundus pigmentation was determined by the color balance of the fundus photographs. The results were then analyzed between the eyes with and without sunset glow fundus (SGF). Results The median age of patients with VKH disease was 58.0 (range 54.0–65.0) years, and median disease duration was 66.4 (range 8.5–147.7) months. In 22 eyes with VKH, the number and total area of HCF were correlated with the degree of fundus pigmentation (ρ = −0.671, P < 0.001; ρ = −0.612, P = 0.002, respectively). The number of HCF was significantly smaller in VKH disease–affected eyes with SGF (median, interquartile range; 134.6, 110.0–159.2) than in those without SGF (229.0, 197.0–261.0) and the eyes of normal controls (211.8, 190.3–233.4). Conclusions HCF distributions correlated with the degree of fundus pigmentation in eyes with VKH disease. Quantitative measurements of HCF on en face OCT images can be a novel tool in evaluating choroidal pigmentation in patients with VKH disease.
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Affiliation(s)
- Young Ho Kim
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Ariunaa Togloom
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Jaeryung Oh
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
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36
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Hu YC, Chen SN. Treatment experience in a HIV-infected patient with Vogt-Koyanagi-Harada disease - a case report. Ocul Immunol Inflamm 2022; 30:1536-1540. [PMID: 34110963 DOI: 10.1080/09273948.2021.1900277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 02/17/2021] [Accepted: 03/01/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Yu Chen Hu
- Department of Ophthalmology, Changhua Christian Hospital, Changhua City, Taiwan
| | - San Ni Chen
- Department of Ophthalmology, Changhua Christian Hospital, Changhua City, Taiwan
- Department of Ophthalmology, Yunlin Christian Hospital, Yunlin, Taiwan
- School of Medicine, Chung-Shan Medical University, Taichung, Taiwan
- Department of Optometry, Da-Yeh University, Changhua, Taiwan
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37
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Souto FMS, Lavezzo MM, Oyamada MK, Yamamoto JH. Vogt‐Koyanagi‐Harada
disease after discontinuation of systemic treatment. Clin Exp Ophthalmol 2022; 50:569-572. [DOI: 10.1111/ceo.14081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 03/26/2022] [Accepted: 04/02/2022] [Indexed: 10/18/2022]
Affiliation(s)
- Fernanda M. S. Souto
- Department of Ophthalmology, LIM‐33, Faculdade de Medicina FMUSP Universidade de Sao Paulo Sao Paulo Brazil
| | - Marcelo M. Lavezzo
- Department of Ophthalmology, LIM‐33, Faculdade de Medicina FMUSP Universidade de Sao Paulo Sao Paulo Brazil
| | - Maria K. Oyamada
- Department of Ophthalmology, LIM‐33, Faculdade de Medicina FMUSP Universidade de Sao Paulo Sao Paulo Brazil
| | - Joyce H. Yamamoto
- Department of Ophthalmology, LIM‐33, Faculdade de Medicina FMUSP Universidade de Sao Paulo Sao Paulo Brazil
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Kesav NP, Kaplan AJ, Hwang CK, Okeagu C, Sen HN. TATTOO-ASSOCIATED CASES OF POSTERIOR SEGMENT UVEITIS WITH VOGT-KOYANAGI-HARADA DISEASE-LIKE FEATURES. Retin Cases Brief Rep 2022; 16:457-460. [PMID: 32502130 DOI: 10.1097/icb.0000000000001007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE To present two patients with treatment-naïve posterior segment uveitis with Vogt-Koyanagi-Harada-like features associated with tattoo-related inflammatory skin changes. METHODS Retrospective report of two cases. RESULTS Using clinical history and multimodal imaging, a diagnosis of posterior segment uveitis with Vogt-Koyanagi-Harada-like features was made in association with tattoo skin changes in both patients. CONCLUSION Physicians should be aware that tattoo-associated posterior segment uveitis with Vogt-Koyanagi-Harada-like features can occur.
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Affiliation(s)
- Natasha P Kesav
- Laboratory of Immunology, National Eye Institute, National Institutes of Health, Bethesda, Maryland
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Vitamin D, the Vitamin D Receptor, Calcitriol Analogues and Their Link with Ocular Diseases. Nutrients 2022; 14:nu14112353. [PMID: 35684153 PMCID: PMC9183042 DOI: 10.3390/nu14112353] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/03/2022] [Accepted: 06/03/2022] [Indexed: 11/21/2022] Open
Abstract
The global prevalence of eye diseases continues to grow, bringing with it a reduction in the activity levels and quality of life of patients, and partial or complete blindness if left untreated. As such, there is considerable interest in identifying more effective therapeutic options and preventive agents. One such agent is vitamin D, known to have a range of anti-cancer, anti-angiogenic, anti-inflammatory and anti-oxidative properties, and whose deficiency is linked to the pathogenesis of a range of cardiovascular, cancer, and inflammatory diseases. This review presents the current stage of knowledge concerning the link between vitamin D and its receptor and the occurrence of eye disease, as well as the influence of analogues of calcitriol, an active metabolite of vitamin D. Generally, patients affected by various ocular disorders have vitamin D deficiency. In addition, previous findings suggest that vitamin D modulates the course of eye diseases and may serve as a marker, and that its supplementation could mitigate some disorders. However, as these studies have some limitations, we recommend further randomized trials to clarify the link between vitamin D and its activity with eye disease.
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Murtaza F, Pereira A, Mandelcorn MS, Kaplan AJ. Vogt-Koyanagi-Harada disease following influenza vaccination. Am J Ophthalmol Case Rep 2022; 26:101516. [PMID: 35464684 PMCID: PMC9020092 DOI: 10.1016/j.ajoc.2022.101516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 02/23/2022] [Accepted: 03/29/2022] [Indexed: 12/20/2022] Open
Abstract
Purpose To report a case of Vogt–Koyanagi–Harada (VKH) disease following influenza vaccination. Observations A 30-year-old Filipino male developed bilateral pain, redness, photophobia, floaters, headache and tinnitus 2 days after receiving the annual influenza vaccine. He presented to the emergency department 5 days after symptom onset. His past medical and ocular history was unremarkable. His best-corrected distance visual acuity (BCVA) was 20/100 in the right eye (OD) and 20/150 in the left eye (OS). Slit-lamp examination revealed fine keratic precipitates and 1+ anterior chamber cells in both eyes (OU). Dilated fundus examination revealed 1+ vitreous cells with trace haze and multiple serous retinal detachments OU. Magnetic resonance imaging (MRI) of the brain and chest X-ray were unremarkable. Serologic testing was negative for infectious, inflammatory and neoplastic causes. The patient tested positive for HLA-DR4. A diagnosis of acute Vogt-Koyanagi-Harada disease was made and high-dose oral prednisone, intravitreal triamcinolone acetonide and mycophenolate mofetil were needed to achieve quiescence. At 6 months follow-up, our patient remains in remission with no active intraocular inflammation or subretinal fluid. His BCVA has improved to 20/50 OD and 20/30 OS. Conclusion and importance The annual influenza vaccine may be a trigger for onset or recurrence of VKH in genetically susceptible individuals.
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Urzua CA, Herbort CP, 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; 12:17. [PMID: 35553272 PMCID: PMC9098759 DOI: 10.1186/s12348-022-00293-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 04/07/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND 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.
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Affiliation(s)
- Cristhian A Urzua
- Laboratory of Ocular and Systemic Autoimmune Diseases, Faculty of Medicine, University of Chile, Santiago, Chile. .,Department of Ophthalmology, University of Chile, Santiago, Chile. .,Facultad de Medicina, Clinica Alemana-Universidad del Desarrollo, Santiago, Chile.
| | - Carl P Herbort
- Retinal and Inflammatory Eye Diseases, Centre for Ophthalmic Specialised Care (COS), Lausanne, Switzerland
| | - Masaru Takeuchi
- Department of Ophthalmology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Ariel Schlaen
- Hospital Universitario Austral, Hospital de Clinicas de Buenos Aires, Buenos Aires, Argentina
| | - Luz E Concha-Del-Rio
- Inflammatory Eye Disease Clinic, Dr. Luis Sanchez Bulnes Hospital, Asociación para Evitar la Ceguera en México (APEC), Mexico City, CDMX, Mexico
| | - Yoshihiko Usui
- Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan
| | - Loreto Cuitino
- Laboratory of Ocular and Systemic Autoimmune Diseases, Faculty of Medicine, University of Chile, Santiago, Chile.,Servicio de Oftalmología, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Ioannis Papasavvas
- Retinal and Inflammatory Eye Diseases, Centre for Ophthalmic Specialised Care (COS), Lausanne, Switzerland
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Skalicky N, Jesse M, Hatz-Wurziger K, Katamay R. [Topical Corticosteroid Monotherapy of a Patient with Vogt-Koyanagi-Harada Syndrome (VKH)]. Klin Monbl Augenheilkd 2022; 239:545-547. [PMID: 35472802 DOI: 10.1055/a-1774-4466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | | | - Katja Hatz-Wurziger
- Vista Augenklinik, Binningen, Schweiz.,Augenklinik, Universitätsspital Basel, Schweiz
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Papasavvas I, Tugal-Tutkun I, Herbort CP. Mechanisms, Pathophysiology and Current Immunomodulatory/Immunosuppressive Therapy of Non-Infectious and/or Immune-Mediated Choroiditis. Pharmaceuticals (Basel) 2022; 15:ph15040398. [PMID: 35455395 PMCID: PMC9031533 DOI: 10.3390/ph15040398] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 03/20/2022] [Accepted: 03/22/2022] [Indexed: 12/19/2022] Open
Abstract
Non-infectious choroiditis comprises immune-mediated diseases resulting from diverse pathophysiological mechanisms. These conditions are sub-divided into two main groups, (1) diseases of the choriocapillaris and (2) diseases of the choroidal stroma. The purpose of this study is to expose the pathophysiology of the most common diseases of both these groups and recommend the optimal immunomodulatory/immunosuppressive therapy of each analyzed condition based on literature data and data from our own centers. Material and Methods: Narrative review. In the group of choriocapillaritis entities or primary inflammatory choriocapillaropathies (PICCPs) including multiple evanescent white dot syndrome (MEWDS), acute posterior multifocal placoid pigment epitheliopathy (APMPPE), idiopathic multifocal choroiditis (MFC) and serpiginous choroiditis (SC), as well as secondary choriocapillaritides including acute syphilitic posterior multifocal placoid chorioretinitis (ASPMPC) and tuberculosis-related SC (TB-SC), were analyzed. In the group of stromal choroidites, HLA-A29 birdshot retinochoroiditis (BRC) and Vogt-Koyanagi-Harada (VKH) disease were included. For each entity a literature search, in the PubMed database, on treatment was performed and analyzed and the therapeutic attitudes of our own centers were presented. Management of immune-mediated choroiditis implies vigorous immunosuppressive therapy given in a prompt and prolonged fashion in most of these entities.
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Affiliation(s)
- Ioannis Papasavvas
- Retinal and Inflammatory Eye Diseases, Centre for Ophthalmic Specialized Care (COS), Rue Charles-Monnard 6, CH-1003 Lausanne, Switzerland;
| | - Ilknur Tugal-Tutkun
- Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey;
| | - Carl P. Herbort
- Retinal and Inflammatory Eye Diseases, Centre for Ophthalmic Specialized Care (COS), Rue Charles-Monnard 6, CH-1003 Lausanne, Switzerland;
- Correspondence:
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Aronson RJ, Pumphrey SA, Robinson N. Unilateral eosinophilic cellulitis leading to implant extrusion after bilateral enucleation in a dog. Clin Case Rep 2022; 10:e05377. [PMID: 35140969 PMCID: PMC8811182 DOI: 10.1002/ccr3.5377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 12/28/2021] [Indexed: 11/18/2022] Open
Abstract
A mixed breed dog underwent bilateral enucleation with orbital implant placement for secondary glaucoma. Subsequent unilateral implant extrusion occurred. An orbital mass histologically consistent with eosinophilic cellulitis was discovered. It may have developed secondary to communication between orbit and skin. Inflammatory processes mimicking neoplasia can cause implant loss post‐enucleation.
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Affiliation(s)
- Riley J. Aronson
- The Department of Clinical Sciences Cummings School of Veterinary Medicine at Tufts University North Grafton Massachusetts USA
| | - Stephanie A. Pumphrey
- The Department of Clinical Sciences Cummings School of Veterinary Medicine at Tufts University North Grafton Massachusetts USA
| | - Nicholas Robinson
- The Department of Biomedical Sciences Cummings School of Veterinary Medicine at Tufts University North Grafton Massachusetts USA
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Bai X, Hua R. Case Report: Vogt-Koyanagi-Harada Syndrome Mimicking Acute Angle-Closure Glaucoma in a Patient Infected With Human Immunodeficiency Virus. Front Med (Lausanne) 2022; 8:752002. [PMID: 35096859 PMCID: PMC8789872 DOI: 10.3389/fmed.2021.752002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 10/28/2021] [Indexed: 11/13/2022] Open
Abstract
Vogt-Koyanagi-Harada disease (VKH) is a rare multisystemic inflammatory autoimmune disorder. Glaucoma secondary to VKH frequently occurs during the recurrent phase of anterior uveitis; however, acute angle-closure glaucoma (ACG) secondary to both VKH and human immunodeficiency virus (HIV) infection has rarely been reported. We describe a case of secondary acute ACG involving VKH, characterized by sudden vision loss, moderately elevated intraocular pressure (IOP), shallow anterior chamber, and fully or partially closed angle, in an HIV-infected patient. Both VKH and HIV infection contributed to the occurrence of ACG due to the leakage and forward rotation of the ciliary body, as well as choroidal effusion. The deterioration of IOP and serous macular detachment were observed after initial corticosteroid therapy. Visual acuity and IOP were improved with subretinal fluid absorption after continued corticosteroid therapy. Understanding the response of IOP and serous macular detachment after corticosteroid therapy is important for clinical practice.
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Affiliation(s)
- Xue Bai
- Department of Ophthalmology, First Hospital of China Medical University, Shenyang, China
| | - Rui Hua
- Department of Ophthalmology, First Hospital of China Medical University, Shenyang, China
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Missaka RFBG, Goldbaum M, Machado CG, Cunningham ET, Souto FMS, Lavezzo MM, da Nóbrega PFC, Sakata VM, Oyamada MK, Hirata CE, Yamamoto JH. Fingerprint sign in Vogt-Koyanagi-Harada disease: a case series. Int J Retina Vitreous 2022; 8:7. [PMID: 35012686 PMCID: PMC8751277 DOI: 10.1186/s40942-021-00356-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 12/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The tomographic finding, which has been called the "fingerprint sign" in en face reconstructions, seems to be the result of a variety of processes that cause distension of the outer plexiform layer (OPL) and the Henle fiber layer (HFL). The aim of this paper is to describe the appearance of concentric rings at the OPL/HFL interface visualized using en face reconstructions of cross-sectional optical coherence tomography images of patients with Vogt-Koyanagi-Harada disease. METHODS Retrospective analysis of images of six eyes of three patients obtained by cross-sectional OCT imaging and en face reconstruction at the level of the OPL/HFL interface. RESULTS All eyes presented with a dentate or saw-tooth pattern of the OPL/HFL interface on cross-sectional OCT with corresponding concentric rings on en face OCT reconstruction, consistent with the recently published "fingerprint sign". Initial OPL/HFL interface changes were observed between the first and fourth months after treatment and resolution of VKHD associated serous retinal detachments. These OPL/HFL interface changes have persisted for many years following the resolution of the active inflammation. CONCLUSIONS Changes in the OPL/HFL interface can be identified following successful treatment of VKHD. These included both a dentate or saw-tooth pattern on cross-sectional imaging and concentric rings or the "fingerprint sign" on en face reconstructions. These changes persisted for many years despite disease quiescence.
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Affiliation(s)
- Ruy Felippe Brito Gonçalves Missaka
- Department of Ophthalmology, LIM-33, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, 01246-000, Brazil. .,Brazilian Vogt-Koyanagi-Harada Disease Study Group, São Paulo, SP, Brazil.
| | - Mauro Goldbaum
- Department of Ophthalmology, LIM-33, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, 01246-000, Brazil
| | - Cleide Guimarães Machado
- Department of Ophthalmology, LIM-33, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, 01246-000, Brazil
| | - Emmett T Cunningham
- West Coast Medical Group, San Francisco, CA, USA.,Department of Ophthalmology, California Pacifical Medical Center, San Francisco, CA, USA.,Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, USA.,The Francis I Proctor Foundation, UCSF School of Medicine, San Francisco, CA, USA
| | - Fernanda Maria Silveira Souto
- Department of Ophthalmology, LIM-33, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, 01246-000, Brazil.,Brazilian Vogt-Koyanagi-Harada Disease Study Group, São Paulo, SP, Brazil
| | - Marcelo Mendes Lavezzo
- Department of Ophthalmology, LIM-33, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, 01246-000, Brazil.,Brazilian Vogt-Koyanagi-Harada Disease Study Group, São Paulo, SP, Brazil
| | - Priscilla Figueiredo Campos da Nóbrega
- Department of Ophthalmology, LIM-33, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, 01246-000, Brazil.,Brazilian Vogt-Koyanagi-Harada Disease Study Group, São Paulo, SP, Brazil
| | - Viviane Mayumi Sakata
- Department of Ophthalmology, Federal University of Paraná, Curitiba, PR, Brazil.,Brazilian Vogt-Koyanagi-Harada Disease Study Group, São Paulo, SP, Brazil
| | - Maria Kiyoko Oyamada
- Department of Ophthalmology, LIM-33, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, 01246-000, Brazil.,Brazilian Vogt-Koyanagi-Harada Disease Study Group, São Paulo, SP, Brazil
| | - Carlos Eduardo Hirata
- Department of Ophthalmology, LIM-33, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, 01246-000, Brazil.,Brazilian Vogt-Koyanagi-Harada Disease Study Group, São Paulo, SP, Brazil
| | - Joyce Hisae Yamamoto
- Department of Ophthalmology, LIM-33, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, 01246-000, Brazil.,Brazilian Vogt-Koyanagi-Harada Disease Study Group, São Paulo, SP, Brazil
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Cristea AP, Stan C. Bilateral multifocal and recurrent chorioretinopathy - case report. Rom J Ophthalmol 2022; 66:373-381. [PMID: 36589323 PMCID: PMC9773119 DOI: 10.22336/rjo.2022.67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2022] [Indexed: 12/24/2022] Open
Abstract
Objective: The aim of this report is to highlight a rare condition that raises serious diagnosis and treatment difficulties. Case presentation: A 34-year-old male patient presented at the Department of Ophthalmology accusing reduced visual acuity (VA), dyschromatopsia and slight photophobia in his left eye (OS). Posterior pole examination revealed serous retinal detachment superior to the optic nerve head in his right eye (OD) and a well-defined macular oedema in the OS. Optical coherence tomography (OCT) confirmed the presence of subretinal fluid accumulations, fundus fluorescein angiography (FFA) revealed punctate hyperfluorescent pinpoint foci in the macular region of both eyes in the early venous phase and dye pooling in the late phase. The first diagnosis was Probable Vogt-Koyanagi-Harada (VKH) syndrome, but the evolution under corticosteroid therapy and shifting of the position of the serous retinal detachments in time, changed the diagnosis to multifocal, recurrent central serous choroidopathy. The patient received treatment with anti-vascular endothelial growth factor (VEGF) agents and presented multiple episodes of partial remission and shift of the subretinal fluid. Conclusions: The persistent, recurrent, multifocal and bilateral exudative retinal detachments raised significant diagnosis difficulties. In the absence of a well-established treatment, the current prognosis is unfavorable. Abbreviations: MARC = multifocal and recurrent choroidopathy, CSCR = Central Serous Chorioretinopathy, RPE = retinal pigment epithelium, CFH = complement factor H, VA = visual acuity, OD = right eye, OS = left eye, OCT = ocular coherence tomography, VEGF = vascular endothelial growth factor, FFA = Fundus fluorescein angiography, p-ANCA = Perinuclear anti-neutrophil cytoplasmic antibodies, PR3 = IgG antibodies against proteinase 3, ANA = antinuclear antibodies, CIC = Circulating immune complexes, CMV = Cytomegalovirus, VKH = Vogt-Koyanagi-Harada.
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Affiliation(s)
| | - Cristina Stan
- Department of Ophthalmology, Emergency County Hospital, Cluj-Napoca, Romania
,Department of Ophthalmology “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
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Lim J, Tan W, Nor N. Hints from the skin beneath: Vitiligo in Vogt–Koyanagi–Harada disease. DERMATOL SIN 2022. [DOI: 10.4103/ds.ds_23_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Herbort CP, 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; 36:29-43. [PMID: 34145419 PMCID: PMC8727674 DOI: 10.1038/s41433-021-01573-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 04/13/2021] [Accepted: 04/21/2021] [Indexed: 02/06/2023] Open
Abstract
Vogt-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.
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Affiliation(s)
- Carl P Herbort
- Inflammatory and Retinal Eye Diseases, , Centre for Ophthalmic Specialised care, Lausanne, Switzerland.
| | - Ilknur Tugal-Tutkun
- Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ahmed Abu-El-Asrar
- Department of Ophthalmology, Dr. Nasser Al-Rashid Research Chair in Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Amod Gupta
- Professor Emeritus, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Masaru Takeuchi
- Department of Ophthalmology, National Defence Medical College, Tokorozawa, Saitama, Japan
| | - Christine Fardeau
- Department of Ophthalmology, Reference center for rare diseases, La Pitié-Salpêtrière Hospital, Paris-Sorbonne University, Paris, France
| | - Alireza Hedayatfar
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Cristhian Urzua
- Laboratory of Ocular and Systemic Autoimmune Diseases, Department of Ophthalmology, Faculty of Medicine, University of Chile, Santiago, Chile
- Facultad de Medicina, Clinica Alemana-Universidad del Desarrollo, Santiago, Chile
| | - Ioannis Papasavvas
- Inflammatory and Retinal Eye Diseases, , Centre for Ophthalmic Specialised care, Lausanne, Switzerland
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Lee KE, Bharadwaj S, Sahoo AK, Yadava U, Kang SG. Determination of tyrosinase-cyanidin-3-O-glucoside and (-/+)-catechin binding modes reveal mechanistic differences in tyrosinase inhibition. Sci Rep 2021; 11:24494. [PMID: 34969954 PMCID: PMC8718538 DOI: 10.1038/s41598-021-03569-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 12/06/2021] [Indexed: 12/13/2022] Open
Abstract
Tyrosinase, exquisitely catalyzes the phenolic compounds into brown or black pigment, inhibition is used as a treatment for dermatological or neurodegenerative disorders. Natural products, such as cyanidin-3-O-glucoside and (-/+)-catechin, are considered safe and non-toxic food additives in tyrosinase inhibition but their ambiguous inhibitory mechanism against tyrosinase is still elusive. Thus, we presented the mechanistic insights into tyrosinase with cyanidin-3-O-glucoside and (-/+)-catechin using computational simulations and in vitro assessment. Initial molecular docking results predicted ideal docked poses (- 9.346 to - 5.795 kcal/mol) for tyrosinase with selected flavonoids. Furthermore, 100 ns molecular dynamics simulations and post-simulation analysis of docked poses established their stability and oxidation of flavonoids as substrate by tyrosinase. Particularly, metal chelation via catechol group linked with the free 3-OH group on the unconjugated dihydropyran heterocycle chain was elucidated to contribute to tyrosinase inhibition by (-/+)-catechin against cyanidin-3-O-glucoside. Also, predicted binding free energy using molecular mechanics/generalized Born surface area for each docked pose was consistent with in vitro enzyme inhibition for both mushroom and murine tyrosinases. Conclusively, (-/+)-catechin was observed for substantial tyrosinase inhibition and advocated for further investigation for drug development against tyrosinase-associated diseases.
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Affiliation(s)
- Kyung Eun Lee
- Department of Biotechnology, Institute of Biotechnology, College of Life and Applied Sciences, Yeungnam University, 280 Daehak-Ro, Gyeongsan, 38541, Gyeongbuk, Korea.
- Stemforce, 313 Institute of Industrial Technology, Yeungnam University, 280 Daehak-Ro, Gyeongsan, 38541, Gyeongbuk, Korea.
| | - Shiv Bharadwaj
- Department of Biotechnology, Institute of Biotechnology, College of Life and Applied Sciences, Yeungnam University, 280 Daehak-Ro, Gyeongsan, 38541, Gyeongbuk, Korea.
- Laboratory of Ligand Engineering, Institute of Biotechnology of the Czech Academy of Sciences, BIOCEV Research Center, Vestec, Czech Republic.
| | - Amaresh Kumar Sahoo
- Department of Applied Sciences, Indian Institute of Information Technology Allahabad, Allahabad, 211015, Uttar Pradesh, India.
| | - Umesh Yadava
- Department of Physics, Deen Dayal Upadhyay Gorakhpur University, Gorakhpur, India.
| | - Sang Gu Kang
- Department of Biotechnology, Institute of Biotechnology, College of Life and Applied Sciences, Yeungnam University, 280 Daehak-Ro, Gyeongsan, 38541, Gyeongbuk, Korea.
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