Vogt–Koyanagi–Harada disease

Figures & data

Figure 1. Fundus photograph of the right eye of a patient with acute Vogt–Koyanagi–Harada disease shows deep, round, white-yellowish lesions, variable in size, located in the posterior pole.

Note the presence of associated exudative retinal detachment, retinal folds and optic disc hyperemia.

Figure 2. Acute Vogt–Koyanagi–Harada disease.

(A) Fundus photography shows bilateral exudative retinal detachment involving the posterior pole with associated retinal and choroidal folds. (B) Early-phase fluorescein angiogram shows areas of delayed choriocapillaris filling. (C) Mid-phase fluorescein angiogram shows multiple pinpoints that enlarge with pooling of dye in subretinal space in the late-phase (D). (E) Optical coherence tomography shows exudative retinal detachment with subretinal septa dividing the subretinal space into several compartments. (F) 10-MHz ultrasonography of the same patient shows diffuse-low to medium-reflective choroidal thickening most marked in the posterior fundus and associated exudative retinal detachment (white arrow). (G) 20-MHz ultrasonography shows better definition of sclero-choroidal limit (blue arrow) and episcleral space (black arrow) with more accurate measurement of choroidal thickening.

Figure 3. A ‘pre-exudative’ stage in a patient with early acute Vogt–Koyanagi–Harada disease.

(A) Fundus photograph of left eye shows optic disc edema and retinal and choroidal folds. There is no evident exudative retinal detachment. (B) Early-phase fluorescein angiography shows hypofluorescent striae and optic disc hyperfluorescence. (C) Optical coherence tomography of the same eye shows multifocal folds of the retinal pigment epithelium and Bruch’s membrane. (D) 10-MHz ultrasonography shows diffuse medium reflective choroidal thickening (white arrow).

Figure 4. Fundus photograph of the right eye of a patient with chronic convalescent Vogt–Koyanagi–Harada disease shows depigmentation of the choroid with typical orange-red ‘sunset glow’ appearance of the fundus.

Note the presence of nummular, round, well-limited chorioretinal depigmented scars located in the midperiphery and focal hyperpigmentation in the foveal area.

Figure 5. Anterior segment photograph of a patient with chronic convalescent phase of Vogt–Koyanagi–Harada disease shows a sunset glow ‘pupil’ appearance and posterior synechiae.

Figure 6. Fundus photograph of the left eye of a patient with chronic convalescent Vogt–Koyanagi–Harada disease shows sunset glow fundus with retinal pigment epithelium migration/clumping and subretinal fibrosis in the posterior pole.

Figure 7. Photograph of a patient with chronic convalescent phase of Vogt–Koyanagi–Harada disease.

(A) Vitiligo on the face and (B) poliosis

Figure 8. Anterior segment photograph shows anterior granulomatous uveitis with mutton-fat keratic precipitates on the corneal endothelium and posterior synechiae in a patient with chronic recurrent Vogt–Koyanagi–Harada disease.

Figure 9. Acute phase Vogt–Koyanagi–Harada disease.

(A) Early-phase indocyanine green angiograms shows a marked choriocapillaris filling delay and (B) choroidal vascular fuzziness due to perivascular leakage. (C) Intermediate-phase indocyanine green angiography shows numerous hypofluorescent dark dots. (D) Late-phase indocyanine green angiography shows optic disc hyperfluorescence.

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