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Delayed fellow eye involvement in patients with Vogt–Koyanagi–Harada disease
  1. R H Roe1,2,
  2. S R Rathinam3,
  3. R W Wong1,2,
  4. H R McDonald1,2,
  5. J M Jumper1,2,
  6. E T Cunningham, Jr1,2
  1. 1
    The San Francisco Retina Research Foundation of St Mary’s Medical Center, San Francisco, California, USA
  2. 2
    Pacific Vision Foundation, California Pacific Medical Center, San Francisco, California, USA
  3. 3
    Aravind Eye Hospital & Post-Graduate Institute of Ophthalmology, Anna Nagar, Madurai, Tamil Nadu, India
  1. Dr E T Cunningham, Jr, 185 Berry Street, Lobby 5, Suite 130, San Francisco, CA 94107, USA; emmett_cunningham{at}yahoo.com

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Vogt–Koyanagi–Harada (VKH) disease is a multisystem autoimmune disorder directed against melanocyte-associated antigens in the skin, inner ear, meninges and uveal tract. Ocular VKH disease typically presents as an acute, bilateral, granulomatous panuveitis associated with optic disc hyperaemia, exudative retinal detachment and multiple pinpoint leaks on fluorescein angiography. We describe here three patients with VKH disease who experienced a delay between first and second eye involvement of 6 years, 2 years and 11 months, respectively.

Case 1

A 45-year-old healthy Asian Indian man with a 6-year history of recurrent, unilateral, panuveitis affecting his left eye presented with decreased vision in his previously unaffected right eye. A review of systems revealed a history of recent neck pain and headache. Best-corrected vision was 20/50-2 on the right and 20/25 on the left. Intraocular pressure was 14 mm Hg bilaterally. Anterior segment examination revealed rare cells in the anterior chamber and anterior vitreous of each …

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