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Subretinal neovascularization in the Vogt-Koyanagi-Harada syndrome

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Abstract

Two Hispanic patients with Vogt-Koyanagi-Harada (VKH) syndrome each developed a disciform lesion involving the macula of one eye several months after the onset of symptoms. Each had extraocular manifestations which included pleocytosis of the cerebrospinal fluid. The disciform lesions were associated with retinochoroidal anastomoses, a finding not previously reported in VKH syndrome. Each patient had a separate extramacular disciform lesion in the same eye. Two other Hispanic patients with diffuse bilateral intraocular inflammation had ocular findings consistent with VKH syndrome. One of these patients developed bilateral peripapillary disciform lesions and the other developed a disciform macular scar in one eye. Fluorescein angiography in each patient showed early irregular hyperfluorescence with late intense staining. The disciform detachments occurred in areas of reactive proliferation of the retinal pigment epithelium, and we postulate that growth of subretinal new vessels occurred through areas of Bruch's membrane that were damaged by the inflammation.

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References

  1. Carlson, M.R. & B.M. Kerman. Hemorrhagic macular detachment in the Vogt-Koyanagi-Harada syndrome. Am. J. Ophthalmol. 84: 632–635 (1977).

    Google Scholar 

  2. Duke-Elder, S. & E.S. Perkins. Uveo-meningitic syndromes (Vogt-Koyanagi-Harada). In: System of ophthalmology. Vol. 9, Diseases of the uveal tract. C.V. Mosby Co., St. Louis, pp. 373–383 (1966).

    Google Scholar 

  3. Frank, K.E. & E.W. Purnell. Subretinal neovascularization following rubella retinopathy. Am. J. Ophthalmol. 86: 462–466 (1978).

    Google Scholar 

  4. Gass, J.D.M. Pathogenesis of disciform detachment of the neuroepithelium. III. Senile disciform macular degeneration. Am. J. Ophthalmol. 63: 617–644 (1967).

    Google Scholar 

  5. Gass, J.D.M. Pathogenesis of disciform detachment of the neuroepithelium IV. Fluorescein angiographic study of senile disciform macular degeneration. Am. J. Ophthalmol. 63: 645–659 (1967).

    Google Scholar 

  6. Gass, J.D.M. Pathologenesis of disciform detachment of the neuroepithelium. V. Disciform macular degeneration secondary to focal choroiditis. Am. J. Ophthalmol. 63: 661–689 (1976).

    Google Scholar 

  7. Gass, J.D.M. Pathogenesis of disciform detachment of the neuroepithelium. VI. Disciform detachment secondary to heredodegenerative, neoplastic and traumatic lesions of the choroid. Am. J. Ophthalmol. 63: 689–711 (1967).

    Google Scholar 

  8. Gass, J.D.M. Choroidal neovascular membranes - their visualization and treatment. Trans. Am. Acad. Ophthalmol. Otolaryngol. 77: OP 310-OP 320 (1973).

    Google Scholar 

  9. Gass, J.D.M. Stereoscopic Atlas of Macular Diseases: Diagnosis and Treatment. Mosby Co., 2nd edition, St. Louis, p. 296–297 (1977).

    Google Scholar 

  10. Gragoudas, E.S. & C.D.J. Regan. Peripapillary subretinal neovascularization in presumed sarcoidosis. Arch. Ophthalmol. 99: 1194–1197 (1981).

    Google Scholar 

  11. Green, W.R. & J.D.M. Gass. Senile disciform degeneration of the macula: Retinal arterialization of the fibrous plaque demonstrated clinically and histopathologically. Arch. Ophthalmol. 86: 487–494 (1971).

    Google Scholar 

  12. Green, W.R. & S.N. Key, III. Senile macular degeneration: A histopathologic study. Trans. Am. Ophthalmol. Soc. 75: 180–254 (1977).

    Google Scholar 

  13. Hilton, G.F. Late serosanguineous detachment of the macula after traumatic choroidal rupture. Am. J. Ophthalmol. 79: 997–1000 (1975).

    Google Scholar 

  14. Hogan, M.J. & L.E. Zimmerman (ed.) Ophthalmic Pathology: An Atlas and Textbook, W.B. Saunders Co., 2nd Edition. Philadelphia, p. 398–401 (1962).

    Google Scholar 

  15. Jampol, L.M., D. Orth, M.J. Daily & M.F. Rabb. Subretinal neovascularization with geographic (serpiginous) choroiditis. Am. J. Ophthalmol. 88: 683–689 (1979).

    Google Scholar 

  16. Kennedy, J.E. & G.N. Wise. Retinochoroidal vascular anastomosis in uveitis. Am. J. Ophthalmol. 71: 1221–1225 (1971).

    Google Scholar 

  17. Krill, A.E. & D. Archer. Choroidal neovascularization in multifocal (presumed histoplasmin) choroiditis. Arch. Ophthalmol. 84: 595–604 (1970).

    Google Scholar 

  18. Manger, C. III. & R.R. Ober. Retinal arteriovenous anastomoses in the Vogt-Koyanagi-Harada syndrome. Am. J. Ophthalmol. 89: 186–191 (1980).

    Google Scholar 

  19. Michelson, J.B., P.E. Michelson & F.V. Chisari. Subretinal neovascular membrane and disciform scar in Behcet's disease. Am. J. Ophthalmol. 90: 182–185 (1980).

    Google Scholar 

  20. Miller, S.A., G.H. Bresnick & S.R. Chandra. Choroidal neovascular membrane in Best's vitelliform macular dystrophy. Am. J. Ophthalmol. 82: 252–255 (1976).

    Google Scholar 

  21. Ohno, S., D.H. Char, S.J. Kimura & G.R. O'Connor. Vogt-Koyanagi-Harada syndrome. Am. J. Ophthalmol. 83: 735–740 (1977).

    Google Scholar 

  22. Owens, P.L., M.F. Goldberg & B.J. Busse. Prospective observation of vascular anastomoses between the retina and choroid in recurrent toxoplasmosis. Am. J. Ophthalmol. 88: 402–405 (1979).

    Google Scholar 

  23. Perry, H.D. & R.L. Font. Clinical & Histopathologic observations in severe Vogt-Koyanagi-Harada syndrome. Am. J. Ophthalmol. 83: 242–254 (1977).

    Google Scholar 

  24. Smith, R.E., J.S. Kelley & T.S. Harbin. Late macular complications of choroidal ruptures. Am. J. Ophthalmol. 77: 650–658 (1974).

    Google Scholar 

  25. Snyder, D.A. & H.H. Tessler. Vogt-Koyanagi-Harada syndrome. Am. J. Ophthalmol. 90: 69–75 (1980).

    Google Scholar 

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Ober, R.R., Smith, R.E. & Ryan, S.J. Subretinal neovascularization in the Vogt-Koyanagi-Harada syndrome. Int Ophthalmol 6, 225–234 (1983). https://doi.org/10.1007/BF00141132

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