Vol.65 No.4 278-286, 2014 Yasuhide KANADA Department of Ophthalmology, Okazaki City Hospital, 3-1 Goshoai, Koryuji-cho, Aichi 444-8553, Japan Vogt-Koyanagi-Harada (VKH) disease is the second most common uveitis in Japan. This is considered an autoimmune disease as the immune system attacks self-melanocytes, and it is characterized by neurological, auditory, and dermatological symptoms in addition to panuveitis. Standard treatment is systemic steroid mass therapy. Also, an inadequate amount of corticosteroid can cause the disease recur or become protracted. Here, we report a case of new-onset VKH disease successfully treated with a combination of ryutanshakanto prepared at Ikkando and goreisan, without any corticosteroids, in a hepatitis B virus carrier. The patient was a 40-year-old male. He visited an eye clinic with bilateral blurred vision, and was diagnosed with bilateral maculopathy at this clinic. He was then referred to our hospital. We diagnosed him with VKH disease and, in accordance with (traditional Japanese) Kampo medicine, also with dampness-heat (shitsunetsu) of the foot s liver meridian with reverting yin (ashi-ketchin-kankei), mild water retention (suitai) and blood stasis (oketsu). We then administered the ryutanshakanto prepared at Ikkando, plus goreisan. His visual acuity consequentially began to improve gradually from the next day, and the disease was finally cured without the administration of any corticosteroid. Thus we believe this suggests that Kampo therapy for VKH disease can be a viable alternative. Vogt-Koyanagi-Harada disease, the ryutanshakanto prepared at Ikkando, goreisan, the foot s liver meridian with reverting yin, ryokeijutsukanto! Vogt
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Vol.65 No.4, 2014 % ' # & & & &! & "% % $ # HBV B HBV COI Vogt Behçet Ohguro N, Sonoda KH, Takeuchi M, et al. The 2009 prospective multi-center epidemiologic survey of uveitis in Japan. Jpn J Ophthalmol Goto H, Mochizuki M, Yamaki K, et al. Epidemiological
Vol.65 No.4, 2014 survey of intraocular inflammation in Japan. Jpn J Ophthalmol Sugita S, Sagawa K, Mochizuki M, et al. Melanocyte lysis by cytotoxic T lymphocytes recognizing the MART-1 melanoma antigen in HLA-A 2 patients with Vogt- Koyanagi-Harada disease. Inter Immunol Sugita S, Takase H, Taguchi C, et al. Occular infiltrating CD 4 T cells from patients with Vogt-Koyanagi-Harada disease recognize human melanocyte antigens. Invest Ophthalmol Vis Sci Vogt Vogt T Vogt Vogt Vogt URL http : //kouseikyoku.mhlw.go.jp/ kantoshinetsu / gyomu / gyomu / hoken _ kikan / tsuchi / documents/h 24_1107_01.pdf Bailey IL, Lovie JE. New design principles for visual acuity letter charts. Am J Optom Physiol Optics Read RW, Holland GN, Rao NA, et al. Revised diagnostic criteria for Vogt-Koyanagi-Harada disease : report of an international committee on nomenclature. Am J Ophthalmol Vogt Yamaki K, Hara K, Sakuragi S. Application of revised diagnostic criteria for Vogt-Koyanagi-Harada disease in Japanese patients. Jpn J Ophthalmol Behçet OCT
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