Unilateral and Atypical Presentation of Vogt-Koyanagi-Harada Syndrome: A Case Report

Abstract

Vogt-Koyanagi-Harada (VKH) disease is a multisystem disorder with ocular manifestations including severe bilateral panuveitis with iridocyclitis, serous retinal detachment, diffuse choroidal swelling and optic disc hyperemia. We report a case of 41-year-old male who presented with diminution of vision in left eye with the presence of yellowish subretinal lesions throughout the posterior pole. There was no evidence of anterior or vitreous inflammation. The fundus fluoresce in angiography revealed early hypofluoroscent lesions with late phase showing multiple areas of pooling with no significant pin point hyperfluorescent lesions. The optical coherence tomography showed undulation of the outer retinal layers. Blood work up was within normal limits, Mantoux test showing 10×8 mm of induration. A differential diagnosis of atypical VKH disease versus central serous retinopathy was established. Oral steroids were started in close monitoring and marked resolution of the retinal lesions was noted. The case presents a unique scenario in which atypical VKH disease mimicked a central serous retinopathy like retinal picture and a correct diagnosis was established with the aid of Optical Coherence Tomograpy (OCT).

Keywords

• optical coherence tomography
• uveitis
• uveomeningitic disease