Vogt-Koyanagi-Harada (VKH-Like) syndrome in human and veterinary medecine : a comparative systemic review of pathophysiology, clinical signs, treatment and prognosis

Abstract

Vogt-Koyanagi-Harada (VKH) disease is a rare autoimmune condition characterized by bilateral granulomatous panuveitis with extra-ocular manifestations in humans. A similar condition, VKH-like or uveodermatologic syndrome (UVDS), is recognized in dogs, predominantly in breeds of Asian origin. In both species, the disease is driven by T lymphocytes targeting melanocyte antigens, triggering a Th1/Th17 inflammatory response. Genetic susceptibility linked to the Major Histocompatibility Complex (HLA/DLA) is well established, while a viral trigger remains hypothetical. Ocular lesions are nearly identical across species. Treatment relies on high-dose systemic corticosteroids combined early with immunosuppressive agents, with therapeutic urgency being a critical prognostic factor. Visual prognosis is significantly better in human medicine, likely because diagnosis occurs earlier through a subjective prodromal stage that is not objectifiable in veterinary patients. This review suggests that both conditions may represent the same pathological entity and advocates for a 'One Health' approach in future research.