Immunohistochemical studies of Vogt-Koyanagi-Harada disease with sunset sky fundus.

We studied Vogt-Koyanagi-Harada disease (VKH) with sunset sky fundus using histopathology and immunohistochemical methods. The materials examined were 4 eyes obtained at autopsy on two patients with VKH. The first patient died 32 months after the onset of VKH, and the other 7 years after onset. Histopathology of the eyes showed scattering infiltration of lymphocytes in the thickened choroid with a remarkable disappearance of choroidal melanocytes. T and B lymphocytes were identified by immunohistochemistry, using monoclonal antibodies. Approximately 70% of the lymphocytes were T cells. In the case 1 patient, the ratio of CD4+ to CD8+ T cells was 2 to 3. Thus, the evidence of T and B lymphocytes in these uveal tissues indicates that the inflammation remained active even at the convalescent stage.