Simultaneous-onset Vogt-Koyanagi-Harada (VKH) disease and secondary glaucoma in a Monozygotic Twin pair – A 10-Year Follow-Up of Cases.
Accept poster if oral is not possible ?
Yes
Purpose
To describe the complex parallel clinical courses, including initial presentation and onset, diagnosis, investigations and long-term management over ten years of these rare cases of simultaneous-onset VKH and its ophthalmic sequelae in a monozygotic twin pair.
Methods
Detailed examination of electronic patient records, dating from initial presentation in December 2014 to present.
Results
Both twins were 22 years old at the time of presentation. Diagnostic criteria for VKH were met in both cases. Case 1 presented typically with panuveitis and multifocal choroiditis. Case 2 presented 2 months later with granulomatous inflammation and associated acute synechial angle closure.
Both patients have been treated extensively for secondary uveitic glaucoma; Case 1 with bilateral Baerveldt tubes and Case 2 with YAG peripheral iridotomies, a Trabeculectomy in one eye and Baerveldt tube in the second eye. Both patients were commenced on immunosuppression with Azathioprine to control ocular inflammation.
Conclusion
Familial cases of VKH are rare and there are exceptionally few cases in the literature of presentation in monozygotic twins. We present a detailed 10-year follow-up of near simultaneous onset VKH, including the diagnostic process, HLA typing, immunosuppression and its response, and the management of secondary glaucoma and ophthalmic sequelae.
Conflict of interest
No
1
Last name
XU
Initials of first name(s)
Z.Y.
Department
University Hospitals Birmingham NHS Foundation Trust
City
Birmingham
Country
United Kingdom
2
Last name
Chan
Initials of first name(s)
E.
Department
University Hospitals Birmingham NHS Foundation Trust
City
Birmingham
Country
United Kingdom
3
Last name
Elsheikh
Initials of first name(s)
S.
Department
University Hospitals Birmingham NHS Foundation Trust
City
Birmingham
Country
United Kingdom
4
Last name
Balasubramaniam
Initials of first name(s)
B.
Department
University Hospitals Birmingham NHS Foundation Trust
City
Birmingham
Country
United Kingdom
5
Last name
Agorogiannis
Initials of first name(s)
G.
Department
University Hospitals Birmingham NHS Foundation Trust
City
Birmingham
Country
United Kingdom
6
Last name
Skew
Initials of first name(s)
H.
Department
University Hospitals Birmingham NHS Foundation Trust
City
Birmingham
Country
United Kingdom
7
Last name
Denniston
Initials of first name(s)
A.
Department
University Hospitals Birmingham NHS Foundation Trust
City
Birmingham
Country
United Kingdom
8
Last name
Patil
Initials of first name(s)
A.
Department
University Hospitals Birmingham NHS Foundation Trust
City
Birmingham
Country
United Kingdom
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