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Vogt-Koyanagi Harada Disease

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

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Vogt-Koyanagi Harada Disease

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

  2. Ocular History • 31 yearwoman • Sudden blurredvisionfrom 2 daysprior

  3. First Presentation • VA: OD 20/200, OS 20/400 • Mild AC cell 1+/4+ • Fundus: • Hyperaemiaofdisc • Exudativeretinaldetachment

  4. Serous detachment • Hyperemia disk

  5. Spectral OCT Serous detachment Serous detachment

  6. Spectral OCT • Posterior retinal irregular profile. • Macular serous detachment

  7. Fundusfluoresceinangiography OD: disc hyperfluorescence OS pinpoint

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

  9. Treatment • Intravenousmethyprednisolone • 250mg IV, 6/6 hours, 3 days • followedby oral prednisone

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

  11. Follow up Week 9

  12. Follow up Week 9

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

  14. Follow up Week 9 Serous detachment RPE line was reformed

  15. Follow up Week 9 Serous detachment

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

  17. 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.

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