Table 1.
Main characteristics and course of HCV-infected patients with VKH-like disease
| Case 1 | Case 2 | Case 3 | |
| Age (yr) | 43 | 51 | 42 |
| Sex | F | F | M |
| HCV genotype liver biopsy (Metavir)1 | 3 | 1 | 1 |
| A1F2 | A1F2 | A3F1 | |
| Anti-HCV therapy | PEG-IFN α-2b + Ribavirin | PEG-IFN α-2b + Ribavirin | PEG-IFN α-2b + Ribavirin |
| Interval before first ocular manifestations2 | 4 mo | 3 mo | 4 mo |
| Ocular manifestations | -Visual acuity 20/200 OS | -Bilateral vision loss | -Bilateral vision loss |
| -Macular edema and a bilateral serous retinal detachment. | -Bilateral uveitis, major papillar and retinal edema | -Episcleritis and bilateral uveitis | |
| Retinal fluorescein angiography | Pin-points and bilateral serous retinal and pigmented epithelium detachments, suggestive of a Vogt-Koyanagi-Harada like [VKH] disease | ||
| Therapeutic management | -PEG-IFN and ribavirin disruption | -PEG-IFN and ribavirin disruption | -PEG-IFN and ribavirin disruption |
| -Methylprednisolone IV and per os | - Methylprednisolone IV and per os | - Methylprednisolone IV and per os | |
| Course | -Complete recovery under low dose steroids (< 10 mg/d) | -Low improvement of ocular lesions | -Partial improvement of ocular lesions |
| -Steroids were stopped after one year of treatment without ocular relapse. | -Cortico-dependency > 25 mg/d | -Cortico-dependency > 25 mg/d | |
| -Failure of cyclosporine course | -Re-introduction of PEG-IFN and ribavirin 5 mo later3 | ||
| -Introduction of azathioprine | -Full recovery of ocular manifestations 10 mo after IFN was reintroduced | ||
1
Metavir scoring system for the appraisal of HCV-related liver disease.
2
Time or interval between introduction of the anti-HCV therapy and the first ocular manifestations.
3
Forcase 3, PEG-IFN and ribavirin was re-introduced because of the high level of cortico-dependency and based upon the reported efficacy of IFN in some cases of severe and refractory uveitis[14].