Surgical Management of Atypical Vogt-Koyanagi-Harada Disease

ABSTRACT

PURPOSE: To report a case of surgical treatment of bilateral bullous exudative retinal detachment associated with Vogt-Koyanagi-Harada disease. CASE SUMMARY: A 64-year-old woman presented with decreased visual acuity, headache, and hearing loss for 2 months. Visual acuity was hand motion in the right eye and light perception in the left eye. Intraocular pressure was 16 mmHg in the right eye and 24 mmHg in the left eye. Slit lamp examimation disclosed corneal edema, conjunctival ciliary injection with chemosis, rubeosis iridis, and posterior synechia in both eyes. Fundus examination demonstrated bilateral bullous exudative retinal detachment. Lumbar puncture revealed pleocytosis and auditory function test showed neurosensory hearing loss. She was diagnosed as having bilateral bullous exudative retinal detachment associated Vogt-Koyanagi-Harada disease. On hospital day 3, intravitreal triamcinolone injection with external subretinal fluid drainage was performed in the right eye and on hospital day 6, intravitreal triamcinolone injection with external subretinal fluid drainage was performed in the left eye. Two months later, best corrected visual acuity was 0.2 in the right eye and 0.04 in the left eye. CONCLUSIONS: Intravitreal trimacinolone acetonide injection with external subretinal fluid drainage is one of the good treatment for bullous exudative retinal detachment associated with Vogt-Koyanagi-Harada disease.