title: Extensive chorioretinal atrophy in Vogt-Koyanagi-Harada disease.
abstract: OBJECTIVE
  To report extensive chorioretinal atrophy during the long-term course of Vogt-Koyanagi-Harada (VKH) disease not treated properly in the initial phase.
  
  
  METHODS
  Four patients with VKH disease were examined more than 10 years after onset of the disease.
  
  
  METHODS
  They presented initially with classic features of VKH disease, except 1 patient who had developed bilateral, acute angle-closure glaucoma as the initial sign. Two patients received systemic corticosteroid therapy at the acute phase of the disease. During the follow-up of 13-34 years subsequent to onset, these patients had chronic recurrent anterior uveitis with apparently stable depigmented fundus. Eventually, they developed diffuse, extensive chorioretinal atrophy that resulted in severe visual loss. One patient had an unusual familial occurrence of the disease.
  
  
  CONCLUSIONS
  Failure to prescribe proper corticosteroid therapy in the initial phase of VKH disease may lead to chronic recurrent uveitis. Long-standing uveitic reactions may eventually result in severe visual loss due to extensive chorioretinal degeneration.
authors.affiliation: Department of Ophthalmology, Kagoshima University Faculty of Medicine, Sakuragaoka, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Sonoda
authors.forename: K
authors.initials: K
authors.lastname: Nakao
authors.forename: N
authors.initials: N
authors.lastname: Ohba
mesh_terms: D000368:Aged; D001284:Atrophy; D002829:Choroid / Q000473:pathology*; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012162:Retinal Degeneration / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D014607:Uveomeningoencephalitic Syndrome / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D014794:Visual Fields
chemical_list: D005938:Glucocorticoids