Arquivos Brasileiros de Oftalmologia
Print version ISSN 0004-2749
DAMICO, Francisco Max et al. New insights into Vogt-Koyanagi-Harada disease. Arq. Bras. Oftalmol. [online]. 2009, vol.72, n.3, pp. 413-420. ISSN 0004-2749. http://dx.doi.org/10.1590/S0004-27492009000300028.
Vogt-Koyanagi-Harada disease (VKH), a well-established multiorgan disorder affecting pigmented structures, is an autoimmune disorder of melanocyte proteins in genetically susceptible individuals. Several clinical and experimental data point to the importance of the effector role of CD4+ T cells and Th1 cytokines, the relevance of searching a target protein in the melanocyte, and the relevance of the HLA-DRB1*0405 in the pathogenesis of the disease. Vogt-Koyanagi-Harada disease has a benign course when early diagnosed and adequatey treated. Full-blown recurrences are rare after the acute stage of Vogt-Koyanagi-Harada disease is over. On the other hand, clinical findings, such as progressive tissue depigmentation (including sunset glow fundus) and uveitis recurrence, indicate that ocular inflammation may persist after the acute phase. Additionally, indocyanine green angiography findings suggest the presence of choroidal inflammation in eyes without clinically detectable inflammation. The aim of this paper is to review the latest research results on Vogt-Koyanagi-Harada disease pathogenesis and chronic/convalescent stages, which may help to better understand this potentially blinding disease and to improve its treatment.
Keywords : Uveomeningoencephalitic syndrome; Uveitis [etiology]; Chronic disease; Autoimune diseases [immunology]; HLA-DR antigens; Melanocytes [immunology]; Review.