A rare case report of peri-papillary choroidal neovascularization in vogt-koyanagi-harada disease

Abstract

Vogt-Koyanagi-Harada (VKH) disease is a bilateral, granulomatous panuveitis with neurologic and cutaneous manifestations. Late complications include cataract, glaucoma, choroidal neovascularization (CNVM), and subretinal fibrosis; the latter two carries poor visual prognosis. We report a known case of VKH complicated with peri-papillary CNVM, who was steroid responder as well as steroid dependent, the patient had recurrent episodes of anterior uveitis with steroid-sparing immunosuppressive therapy. Because of the recurrent and uncontrolled inflammation, she developed peri-papillary CNVM in the right eye, which was effectively treated with intravitreal bevacizumab. Even though CNVM is a known complication of VKH, peri-papillary CNVM occurs very rarely and is least reported in the literature. The main therapeutic goal in VKH is to control underlying recurrent inflammation to prevent late complications.