Vogt-Koyanagi-Harada syndrome in children

Introduction: Uveitis in children accounts for 5% to 10% of all uveitis cases. Some causes such as Vogt-Koyanagi-Harada syndrome rarely affect young children. We report two cases. Case report: No.1: A 9-year-old girl was followed up for severe and chronic total uveitis. General fundus depigmentation with several white and yellowish rounded lesions in peripheral fundus suggested the diagnosis of Vogt-Koyanagi-Harada, which was confirmed by the development of areas of vitiligo in the lumbar region. The patient was treated with a bolus of corticosteroid therapy. No. 2: A 12-year-old girl had bilateral uveopapillitis and the clinical initial examination and laboratory evaluation failed to provide a diagnosis. The patient was also treated with a bolus of corticosteroid therapy and then high-dose oral prednisone. After several months, the patient's examination showed a sunset glow fundus with several white and yellowish rounded lesions in peripheral fundus. Discussion: Vogt-Koyanagi-Harada syndrome rarely affects young children, so the diagnosis may be difficult if the extraocular manifestations are not present. The bolus of corticosteroid therapy and cytotoxic agents may be necessary and the prognosis may be poor in severe cases.