Criteria for the diagnosis of the Vogt-Koyanagi-Harada Syndrome:
(1) absence of previous ocular trauma or surgery
(2) at least 3 of the following:
(2a) bilateral iridocyclitis
(2b) posterior uveitis (including exudative retinal detachment or sunset glow fundus)
(2c) central nervous system problems: tinnitus, vertigo, dysacusis, meningism (with fever, headache, nausea, vomiting), cranial nerve dysfunction, cerebrospinal fluid pleocytosis
(2d) cutaneous findings: alopecia, poliosis (premature greying of the hair), vitiligo
Additional tests may be needed to exclude disorders in the differential diagnosis:
(1) syphilis
(2) Lyme's disease serology
(3) autoimmune disorders (ANA, RF, etc.)
(4) chest X-ray or other tests to exclude sarcoid
(5) others
Additional studies useful in confirming the diagnosis:
(1) fluorescein angiography
(2) HLA typing (HLA-DR4, HLA-Dw53, others)
Limitations:
• Patients may present with incomplete or delayed appearance of the extraocular manifestations, especially if treated early with steroids or immunosuppressive agents.
• The patterns of symptoms may vary between racial groups.
