Vogt-Koyanagi-Harada (VKH) Disease Differential Diagnoses

Updated: Mar 09, 2023
  • Author: Fatma Zaguia, MD; Chief Editor: Hampton Roy, Sr, MD  more...
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Diagnostic Considerations

Misdiagnosis of infectious uveitis can lead to inappropriate treatment and potential toxicity, while losing valuable ground without the needed steroid therapy. On the other hand, infectious uveitis misdiagnosed as Vogt-Koyanagi-Harada (VKH) disease and treated with systemic immunosuppression can lead to disastrous results. In particular, patients with syphilis or tuberculosis may demonstrate significant deterioration when treated with steroids alone prior to aggressive appropriate antibiotic therapy. [56]

Conditions to consider in the differential diagnosis of Vogt-Koyanagi-Harada disease include the following:

  • Sympathetic ophthalmia

  • Intraocular lymphoma

  • Bilateral diffuse uveal melanocytic proliferation

  • Metastatic carcinoma

  • Idiopathic uveal effusion syndrome

  • Benign reactive lymphoid hyperplasia

  • Toxemia of pregnancy

  • Sarcoidosis

  • Vitiligo with poliosis

  • Scleritis

  • Peripheral anterior synechia

  • Tuberculosis

  • Anterior granulomatous uveitis

  • Intermediate uveitis

  • White dot syndromes

  • Alezzandrini syndrome

  • Alopecia areata

  • Piebaldism

  • Vitiligo

  • Ocular manifestations of syphilis

Differential Diagnoses