Intravitreal bevacizumab injection for persistent serous retinal detachment associated with Vogt–Koyanagi–Harada disease

Abstract

To introduce a case of Vogt-Koyanagi-Harada (VKH) disease in which the serous retinal detachment (SRD), refractory to the systemic steroid therapy, was resolved in a short time after an intravitreal injection of bevacizumab. Interventional case report to show the effect of bevacizumab for the SRD in a VKH patient. A 42-year-old woman, diagnosed with VKH disease, showed decreased visual acuities and multiple SRDs in both eyes. The best-corrected visual acuity (BCVA) was FC 30 cm in both eyes. On optical coherence tomography (OCT), multiple SRDs were confirmed. On OCT, the height of SRD in the central fovea area was 1119 μm in the right eye and 1151 μm in the left eye. After high-dose steroid treatment for 5 weeks, the SRD in the left eye was completely resolved, however, the SRD in the right eye was persisted. At the time, the height of SRD in the right eye was 884 μm and the BCVA was 0.1. For the treatment of persistent SRD causing a decreased visual acuity despite a long-term high-dose course of systemic steroid therapy, an intravitreal injection of 1.25 mg bevacizumab was performed for the right eye, following an informed consent. One week later, there was fast and complete reabsorption of multiple SRDs in the right eye. The retinal thickness in the foveal area was measured to be 189 μm by OCT and the BCVA was improved to 0.7. An intravitreal injection of bevacizumab combined with systemic steroid in VKH is expected to shorten the time for the persistent presence of SRD and to prevent the permanent visual impairment.