Evidence map›Paper›PMID 42334499›Full record

ArticleJournal of ophthalmic inflammation and infection2026

Late-onset optic disc swelling-type Vogt-Koyanagi-Harada disease: diagnostic value of longitudinal multimodal imaging.

Tetiana Goncharova, Sara Garcia-Hidalgo, Oscar Balaguer Sole, Armand Pairó-Salvador, Yann Bertolani, Eric Kirkegaard-Biosca, Laura Distefano

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Article in Journal of ophthalmic inflammation and infection, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Tetiana GoncharovaOphthalmology Department, Vall d'Hebron University Hospital, Passeig de la Vall d'Hebron 129, Barcelona, 08035, Spain. tetiana.goncharova.simon@gmail.com.ORCID http://orcid.org/0009-0001-2060-5870
Sara Garcia-HidalgoOphthalmology Department, Vall d'Hebron University Hospital, Passeig de la Vall d'Hebron 129, Barcelona, 08035, Spain.
Oscar Balaguer SoleOphthalmology Department, Vall d'Hebron University Hospital, Passeig de la Vall d'Hebron 129, Barcelona, 08035, Spain.
Armand Pairó-SalvadorOphthalmology Department, Vall d'Hebron University Hospital, Passeig de la Vall d'Hebron 129, Barcelona, 08035, Spain.
Yann BertolaniOphthalmology Department, Vall d'Hebron University Hospital, Passeig de la Vall d'Hebron 129, Barcelona, 08035, Spain.
Eric Kirkegaard-BioscaOphthalmology Department, Vall d'Hebron University Hospital, Passeig de la Vall d'Hebron 129, Barcelona, 08035, Spain.
Laura DistefanoOphthalmology Department, Vall d'Hebron University Hospital, Passeig de la Vall d'Hebron 129, Barcelona, 08035, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo describe an atypical late-onset presentation of Vogt-Koyanagi-Harada (VKH) disease initially interpreted as autoimmune glial fibrillary acidic protein astrocytopathy (GFAP-A) in association with an ovarian teratoma.

methodsA 59-year-old woman presented with bilateral optic disc edema, visual field defects, and headache following a flu-like illness. Comprehensive ophthalmologic, neurologic, and systemic evaluation was performed, including multimodal ocular imaging, cerebrospinal fluid (CSF) analysis with antibody testing, and neuroimaging. Clinical course and response to corticosteroid therapy were assessed longitudinally.

resultsInitial findings, including CSF anti-GFAP positivity, lymphocytic pleocytosis, white matter lesions, and an ovarian teratoma, supported a diagnosis of GFAP-A. However, sequential multimodal imaging revealed diffuse, steroid-responsive choroidal inflammation with choroidal thickening, folds, mild subretinal fluid, hypocyanescent dark dots on indocyanine green angiography, fluorescein angiography pinpoints, and bilateral hot discs. Granulomatous anterior uveitis and subsequent choroidal depigmentation further supported VKH. Bilateral sensorineural hearing loss was also consistent with this diagnosis. The longitudinal ocular phenotype proved more consistent with VKH than with primary astrocytopathy-related optic neuropathy.

conclusionsLate-onset VKH may present predominantly with optic disc edema and central nervous system involvement, closely mimicking inflammatory neurologic disease. Recognition of subtle choroidal inflammation and integration of longitudinal multimodal imaging are essential to avoid misdiagnosis and guide appropriate immunosuppressive management.

Indexed as

Bilateral optic disc edemaChoroidal inflammationGlial fibrillary acidic protein astrocytopathyMultimodal imagingOvarian teratomaVogt–Koyanagi–Harada disease

Identifiers

PMID42334499
PMCPMC13547191

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.