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Ophthalmic Images
May 14, 2020

Serous Macular Detachment in Probable Vogt-Koyanagi-Harada Syndrome

Author Affiliations
  • 1Stanford University School of Medicine, Stanford University, Palo Alto, California
  • 2Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, California
JAMA Ophthalmol. 2020;138(5):e191981. doi:10.1001/jamaophthalmol.2019.1981

A healthy Asian man in his 20s presented with 4 days of bilateral vision loss and headache. He had serous retinal detachments involving the macula of the right and left eyes (Figure, A). Probable Vogt-Konayagi-Harada (VKH) disease was determined after other etiologies were ruled out because inflammatory and infectious markers and viral serology results were all negative.

The patient was treated with 1 g of intravenous methylprednisolone for 3 days followed by 60 mg of prednisone daily. The treatment was associated with decreased subretinal fluid under the macula and improvement in visual acuity from 20/200 to 20/50 was noted within 2 weeks, with continued resolution of subretinal fluid at 2 months in the right and left (Figure, B) maculae. Prednisone was tapered and discontinued after 4 months. The disease has since resolved without the need for further treatment. No recurrences have been noted 1 year after corticosteroid therapy was discontinued.

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