Vogt-Koyanagi-Harada syndrome, also called Harada's disease, is an acute inflammatory, immune-mediated disorder that typically affects bilateral eyes of middle aged adults and involves melanocyte-containing organs such as the skin, ear, meninges, and eye. Acute exudative panuveitis occurs in both eyes and causes ocular irritations and visual loss.
The fundus photographs illustrate typical fundus apperance of the disease. The acute the phase of the disease is featured by neurosensory retinal detachments associated with multiple loci of aggressive choroidal exudations. Some patients may present with predominant optic disk swelling. A large dose of systemic corticosteroids is a rewarding treatment for a rapid resolution of exudative lesions(A-E). Lower photographs(F,G) illustrate a common outcome of Harada's disease, "sun-set glow" albinotic fundus, often accompanied by cutaneous pigment deficiencies, because of damaged melanocytes. The disease is essentially benign when managed properly, but it may sometimes become smoldering and result in development of retinal and choroidal neovascularization, severe chorioretinal atrophy, and secondary glaucoma(H).

HARADA, Einosuke (1892-1946)

Japanese ophthalmologist. He graduated from Tokyo University in 1917 and studied Ophthalmology under Prof. J. Komoto and Prof. S. Ishihara. In 1922, he discovered a rare case of acute uveitis with bilateral retinal detachment. He compiled similar cases and established a new clinical entity, which is now named "Harada disease". Later it was found that this disease together with the diseases described by A. Vogt and Y. Koyanagi is an expression of the same disease entity, i.e., Vogt-Koyanagi-Harada disease (Vogt-Koyanagi-Harada syndrome,VKHsyndrome). In 1930 he started to practice in the city of Nagasaki; his hospital was destroyed by the atomic bomb. Although he survived the bomb, he died before he could restart practice. VKH soon proved to be the major uveitis in Japan. Its pathogenesis is now considered immune-mediated, involving individuals having specific immunogenetic predispositIon. (International Biography and Bibliography of Ophthalmologists and Vision Scientists,IBBO. Jean-Paul Wayenborgh, Saiichi Mishima and C. Richard Keeler. J.-P. Wayenborgh, Belgium, 2002)