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A 41-year-old man with bilateral, painless loss of vision
Digital Journal of Ophthalmology 2021
Volume 27, Number 4
November 5, 2021
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Michael Chang, BS | School of Medicine, University of Maryland, Baltimore, Maryland Kin K. Yee, MD | Department of Ophthalmology, Georgetown University, Washington, DC
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| Treatment | | The patient was diagnosed with probable Vogt-Koyanagi-Harada (VKH) disease based on the constellation of signs and symptoms. The presence of panuveitis made hypertensive retinopathy and central serous chorioretinopathy less likely. Similarly, the B-scan findings and lack of ocular trauma or eye surgery ruled out posterior scleritis and sympathetic ophthalmia (Figure 5). The patient was started on 60 mg of oral prednisone and prednisolone acetate 1% drops to each eye every 6 hours. His vision rapidly improved after initiating treatment. Six weeks later his visual acuity was 20/20-2 in both eyes, with resolution of anterior and posterior inflammation and serous detachments. Ten weeks after treatment, OCT of both eyes showed resolution of subretinal fluid (Figure 6). He was tapered off oral prednisone over 6 months. The patient did not experience any systemic symptoms during the course of disease and remained free of recurrent inflammation on his last follow-up examination, 11 months after his initial presentation. | |
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Figure 6.
Retinal OCT 10 weeks after treatment demonstrates resolution of subretinal fluid in both the right (A) and left (B) eyes; the left eye shows patchy loss of the ellipsoid zone.
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