Vogt-Koyanagi Harada Disease Fernando Oréfice Juliana Lambert Oréfice Centro Brasileiro de Ciências Visuais- Brazil

Ocular History 31 year woman Sudden blurred vision from 2 days prior

First Presentation VA: OD 20/200, OS 20/400 Mild AC cell 1+/4+ Fundus: Hyperaemia of disc Exudative retinal detachment

Serous detachment Hyperemia disk

Spectral OCT Serous detachment Serous detachment

Spectral OCT Posterior retinal irregular profile. Macular serous detachment

Fundus fluorescein angiography OD: disc hyperfluorescence OS pinpoint

Diagnosis Vogt-Koyangi Harada Disease Involvement of the optic nerve very significant justifies a more aggressive treatment.

Treatment Intravenous methyprednisolone 250mg IV, 6/6 hours, 3 days followed by oral prednisone

Follow up - Week 9 VA: OD 20/20, OS 20/20 AC cell 0+/4+ Oral prednisolone

Follow up Week 9

Follow up Week 9

Follow up Week 9 OD: Baseline: Disc hyperfluorescence Week 09: Normal fundus fluorescein OS: Baseline: Macular pinpoint

Follow up Week 9 Serous detachment RPE line was reformed

Follow up Week 9 Serous detachment

Follow up Week 9 OCT Baseline: Macular serous detachment. Week 9: RPE line was reformed

Conclusion Early and aggressive high-dose systemic corticosteroid therapy has become the mainstay therapy of VKH disease. Quick answer to the treatment Patients with VKH disease adequately treated with corticosteroids have a favorable visual prognosis.