Unilateral Presentation of Vogt-Koyanagi-Harada Syndrome.

Seyedeh Maryam Hosseini,Marjan Mazouchi,Maryam Dourandish

doi:10.18502/jovr.v15i1.5954

Abstract

PurposeTo report a case of acute Vogt-Koyanagi-Harada (VKH) disease with unilateral clinical manifestations followed by late fellow eye involvement.Case ReportThis case report reviews the 12-month follow-up observation of a 44-year old woman who presented to the emergency department with unilateral progressive and painless visual blurring. Ophthalmoscopic findings, best-corrected visual acuity (BCVA), fluorescein angiography (FAG), enhanced-depth optical coherence tomography (EDI-OCT), indocyanine green angiography, and response to treatment were evaluated. Her BCVA was 20/50 (logMAR: 0.4) in the right eye and 20/20 (logMAR: 0) in the left eye. Eye examination revealed optic disc swelling and multiple serous retinal detachments in the right eye and a normal left eye. She had headache, dysacusia, and mild hearing problem. Her past ocular and drug histories were unremarkable. Retinal imaging revealed characteristic features of VKH in the right eye. All laboratory testing results were inconclusive. VA and OCT findings significantly improved following the treatment with methylprednisolone 1 g/day continued by tapering dose of oral prednisolone. Two months after the presentation and during prednisolone tapering, VA of the left eye decreased and fundus examination revealed multiple serous retinal detachments in this eye.ConclusionOphthalmologists should recognize unilateral and asymmetrical VKH disease with subtle systemic involvement.

Highlights

We report an interesting case of clinically unilateral probable Vogt-Koyanagi-Harada disease (VKH) with subclinical fellow eye involvement on indocyanine angiography (ICGA), which progressed to clinical involvement later
We introduce a case with unilateral clinical presentation, who had abnormalities in ICGA of both eyes
According to the current revised diagnostic criteria, bilateral ocular involvement is necessary for the diagnosis of VKH, there are a few reports of unilateral or asymmetrical ocular involvement.[9, 10, 12, 13]

Summary

Introduction

A Case of Unilateral VKH Syndrome; Hosseini et al disorder of unknown cause that is characterized by bilateral panuveitis, iridocyclitis, exudative retinal detachment, and optic disc swelling. Many reports have indicated that patients may not manifest all diagnostic criteria but seem to have the disease.[1] we report an interesting case of clinically unilateral probable VKH with subclinical fellow eye involvement on ICGA, which progressed to clinical involvement later. Fundus examination revealed optic disc swelling and multiple serous retinal detachments in the right eye and normal left retina.

Results

Conclusion