Diagnosis of Vogt–Koyanagi–Harada Syndrome(VKH)

Diagnosis of Vogt–Koyanagi–Harada Syndrome(VKH)👌
1.No history of penetrating ocular trauma or surgery preceding the initial onset of uveitis.
2.No clinical or laboratory evidence suggestive of other ocular disease entities.
3.Bilateral ocular involvement (a or b must be met, depending on the stage of disease when the patient is examined).
A.Early manifestations of disease:
i. evidence of diffuse choroiditis (with or without anterior uveitis, vitreous inflammatory reaction, or optic disk hyperemia) which may manifest as:
a) focal areas of subretinal fluid, or
b) bullous serous retinal detachments
B.Late manifestations of disease:
i. History suggestive of prior presence of early findings noted in (3A) and either (ii) or (iii) below, or multiple signs from 3
ii. Ocular depigmentation: either
a) sunset glow fundus or
b) Sugiura's sign
iii. Other ocular signs including
a) nummular chorioretinal depigmented scars, or
b) retinal pigment epithelium clumping and/or migration, or
c)  recurrent or chronic anterior uveitis
4.Neurological/auditory findings (may resolve by time of evaluation)
a) Meningismus (malaise, fever, headache, nausea, abdominal pain, stiffness of the neck and back, or a combination of these factors); note that headache alone is not sufficient to meet the definition of meningismus
b) Tinnitus
c) Cerebrospinal fluid pleocytosis
5.Integumentary finding (not preceding onset of central nervous system or ocular disease)
a) Alopecia, or
b) Poliosis, or
c) Vitiligo.
Complete VKH: Criteria 1–5 must be present.
Incomplete VKH: Criteria 1–3 and either 4 or 5 must be present.
Probable VKH (isolated ocular disease): Criteria 1–3 must be present.