A case of unilateral focal choroidal excavation in Vogt-Koyanagi-Harada disease; case report

Abstract

Purpose: To report a rare case of Vogt-Koyanagi-Harada (VKH) disease complicated by unilateral focal choroidal excavation (FCE). Methods: A 25-year-old male patient with bilateral blurred vision, tinnitus, and headache. Initial examination revealed multiple sensory retinal detachments in both eyes. Optical coherence tomography (OCT), fundus fluorescein angiography (FFA), and other diagnostic tests confirmed VKH. The patient was treated with intravenous methylprednisolone followed by oral prednisolone. Results: Following treatment, the exudative retinal detachments resolved, and a subfoveal FCE was observed in the right eye. OCT imaging revealed choroidal inflammation and retinal pigment epithelium (RPE) disruption. The patient's visual acuity improved, but the FCE persisted during follow-up, suggesting a potential association between inflammation and the development of FCE in VKH. Conclusions: This case highlights the rare occurrence of FCE during the course of VKH disease, suggesting that inflammatory disruption of the RPE and choroidal atrophy may contribute to FCE formation. Comprehensive retinal imaging in VKH patients is essential for detecting such complications, which may influence long-term visual outcomes. This case adds to the limited literature on the relationship between ocular inflammation and choroidal excavation, providing valuable insights for future clinical management.

Keywords

• Focal choroidal excavation (FCE)
• Vogt–Koyanagi–Harada (VKH)
• Choroidal inflammation
• Case report