Optical coherence tomography angiography in the diagnosis and follow-up of vogt-koyanagi-harada syndrome

Abstract

An 18-year-old female patient applied to our clinic owing to sudden visual loss which started 3 days ago on the right eye. There were +3 cells in the anterior chamber, +3 cells in the vitreous and multiple serous retinal detachment in the right eye. The anterior segment and fundus were normal in the left eye. Optic disc leakage in both eyes and hyperfluorescent areas due to subretinal fluid pooling in the phase in the right eye were detected in fundus fluoresceine angiography. Hypofluorescent foci were detected in the mid-late phase in both eyes in indocyanine green angiography. A marked thick choroid (690 ?m) in optical coherence tomography and decreased choriocapillaris flow rate in right eye compared to left eye in optical coherence tomografi angiography were detected. Pleocytosis was detected in the lumbar puncture. Based on these findings, the patient was diagnosed as bilateral asymmetric onset acute Vogt-Koyanagi-Harada and treated with 1 g intravenous pulse steroid treatment. On the third day of the pulse steroid treatment, the amount of subretinal fluid significantly decreased and choriocapillaris flow rate significantly increased in the right eye and slightly increased in the left eye. On the 7th day, 1 mg / kg / day oral steroid and 100 mg azothiopurine treatment were started after complete resolution of subretinal fluid and increase of visual acuity up to 0.5. © 2020 Gazi Eye Foundation. All rights reserved.