Vogt-Koyanagi-Harada (VKH) disease, a rare autoimmune disorder that affects multiple systems in the body, has been found to have an association with COVID-19 infection and vaccination. Researchers from Sapienza University of Rome have provided an overview of VKH disease and its connection to COVID-19. They found no significant differences in the epidemiology and clinical findings of VKH disease in the COVID era compared to before. All patients in the study responded well to corticosteroid therapy, and the final visual prognosis was good. However, it is important for ophthalmologists to be aware of the possibility of VKH disease occurring or recurring after COVID-19 vaccination, particularly in genetically susceptible individuals.
COVID-19, caused by the SARS-CoV-2 virus, is known to have a spike protein that binds to the ACE-2 receptor, facilitating its entry into host cells. Cases of VKH disease have been reported after COVID-19 infection, suggesting that the virus may act as a trigger. The time between COVID-19 infection and the onset of VKH symptoms was found to be around 17.5 to 19.75 days. The majority of patients in the study were women, and all received oral steroids as treatment.
The association between vaccines and VKH disease has been reported with various types of vaccines, including hepatitis B, influenza, yellow fever, and tuberculosis vaccines. It is believed that the administration of adjuvants in genetically susceptible individuals may play a role in the development of VKH disease after vaccination. The presence of the HLA-DR4 antigen, a genetic factor, has been linked to the onset or recurrence of VKH disease after COVID-19 infection and vaccination.
VKH disease is characterized by the autoimmune targeting and destruction of melanocytes, leading to inflammation in various parts of the body. It is commonly reported as a uveitic entity after COVID-19 vaccination. In addition to viral infections, an association between VKH disease and microbial infections has also been observed. Molecular mimicry, where a vaccine component shares antigenic features with host cells, may explain the link between VKH disease and COVID-19 infection/vaccination.
VKH disease is a complex autoimmune disorder that primarily affects the eyes but can also involve other systems in the body. It is more prevalent in pigmented races and women. The disease has distinct clinical stages, including prodromal, acute uveitic, chronic, and chronic recurrent stages. It can also affect the integumentary, central nervous, and auditory systems. Diagnosis is based on a combination of clinical features and findings from systemic or ocular examinations. High-dose corticosteroid therapy is the main treatment choice, and early initiation is crucial for better outcomes.
VKH disease is a complex autoimmune disorder that necessitates prompt diagnosis and treatment. The association between VKH disease and COVID-19 infection/vaccination emphasizes the need for further research to better understand the triggers and pathogenesis of the disease. Ophthalmologists should be mindful of the potential occurrence or recurrence of VKH disease after COVID-19 vaccination, especially in individuals with genetic susceptibility.