International Journal of Preclinical and Clinical Research

Abstract

To report a case of smoldering vogt-koyanagi-harada disease with extraocular involvement. A 45-years-old male presented with diminished vision in BE for one 1 — week associated with redness, pain, watering, intolerance to light with tinnitus also gives a history of similar complaints, in the past 2years. Examination revealed both eye visual acuity CF1/2 meters. Slit-lamp examination showed conjunctival ingestion, mutton fat KP’s, sluggishly reactive pupil with multiple broken posterior synechaie. Fundus showed grade 2 vitreous cells with multiple opacities, diffuse retinochoroidal thickening with disc edema. Tonometry was 16 and 29 mmhg respectively. B-scan showed multiple vitreous echo’s, diffuse retino-choroidal complex thickening with multiple shallow serous retinal detachment. After routine investigations patient was started on topical and systemic steroids. Lumbar puncture showed 82% lymphocytic pleocytosis. The patient recovered well with 6/24 vision in BE with a resolution of fundus finding at 6week followup. High index of suspicion, timely diagnosis and management are crucial to prevent vision threatening complications in VKH disease.

Keywords: Vogtkoyanagiharada disease; retinochoroidal thickening; serous retinal detachment; tinnitus; CSF pleocytosis; systemic steroids