Gleaming in the gloom—A striking bilateral multimodal imaging canvas of vogt-koyanagi-harada syndrome in a patient with poor adherence to therapy

Abstract

Vogt-Koyanagi-Harada (VKH) syndrome is a rare bilateral granulomatous panuveitis typically affecting the more pigmented races, and women more than men. VKH syndrome is theorized due to a T-cell-mediated autoimmune reaction against antigens related to melanin and melanocytes, that may happen due to cutaneous or viral triggers. Along with the clinical evaluation, it is mandatory to utilise additional investigative modalities such as fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA), optical coherence tomography (OCT) and ultrasonography, which will help pick up pathognomonic signs, that can be missed on clinical evaluation. In this manuscript, we have reported striking multimodal images of a VKH patient with poor adherence; and have emphasized early detection, initiation of therapy without delay, aggressive therapy, good compliance, very slow tapering of oral steroids and use of immunosuppressants for a good visual prognosis.

Keywords

• adherence
• ffa
• icga
• multimodal imaging
• vkh syndrome