Título / Title

BILATERAL SEROUS RETINAL DETACHMENT IN A CASE OF VOGT-KOYANAGI-HARADA SYNDROM

Introdução / Purpose

Demonstrate an atypical case of bilateral serous retinal detachment in a patient diagnosed with vogt-koyanagi-harada disease (VKHD).

Material e Método / Methods

A review of the patient's medical record was performed. where general information about it was obtained.

Resultados / Results

55-year-old female patient searched a service with a sudden bilateral visual and auditory deficit. At ophthalmologic examination visual acuity was light perception in both eyes, biomicroscopy presented transparent cornea with anterior chamber reaction of 2/4, anterior synechiae, phakic with N1 cataract (by LOCS-2 classification) bilaterally. fundus was seen with difficulty and the ocular ultrasonography was performed, showing aspect of serous retinal detachment and inflammatory process.
Clinical and laboratory exams without alterations, except for the lumbar puncture showed a pleocytosis. Nuclear magnetic resonance of skull, orbits and auditory conduit showed only choroidal hypersignal compatible with bilateral retinal detachment. A Brainstem Evoked Response Audiometry demonstrated profound sensorineural hearing loss. The clinical aspect associated with the findings in the exams made the diagnosis for VKHD, even without dermatological alterations. Realized a pulse therapy with methiprednisolone for 3 days, followed by prednisone and cyclosporine as immunosuppressant. The optical coherence tomography performed 2 months after the treatment demonstrated the retina applied with presence of Dalen Fuchs nodules in the outermost layers of the retina in both eyes.

Discussão e Conclusões / Conclusion

Serous retinal detachment is a rare condition there is more common in some pathologies, so is important know the differential diagnoses for this kind of patient. Prompt diagnosis followed by early, aggressive and long-term treatment with high-dose corticosteroids is most often ensued by good visual outcomes.

Palavras Chave

Serous retinal detachment, vogt-koyanagi-harada disease, uveitis, optic coherence tomography