Title
EARLY TREATMENT OF INCOMPLETE VOGH SYNDROME-KOYANAGI-HARADA
Introduction
Vogt-Koyanagi-Harada (VKH) is a multisystemic syndrome, it is suggested that its pathophysiology is based on autoimmunity against melanocytes. In the eye, the disease initially affects the uvea and choroid, evolving with serous retinal detachment (SRD). Disc edema may also be present. Patients in the early stage of VKH disease rarely present the complete form because it includes both acute and chronic signs, and when they receive adequate doses of immunosuppression soon after the onset of the disease, they often obtain good visual results.
Methods
Review of the patient's medical record and literature review on the subject in the period of January / 2020.
Results
Female, third decade of life, complaint of sudden low vision in both eyes (BE) associated with severe headache and tinnitus. At the first examination presented visual acuity (VA) of counting fingers at 1 meter BE, in the biomicroscopy of the anterior chamber reaction of 2+/4+, and intraocular pressure within normal limits. Complementarily, the angiofluoresceinography (AF) showed hyperfluorescence by central pooling and by leakage in the periphery, the wide field retinography showed SRD with several pockets, and the optical coherence tomography pointed the presence of subretinal fluid, folds and detachment of retinal pigmental epithelium. Pulsotherapy was performed with methylprednisolone for 3 days, oral prednisone 100mg/day for another 15 days (already showing improvement in VA 20/25 in the right eye and 20/30 in the left eye), then corticosteroid regression was maintained for 6 months, with complete resolution of the condition.
Discussion
Complementary tests are important for the early diagnosis of VKH, as they speed up the diagnosis of the disease when it is still classified as incomplete, increasing the chance that the treatment will be instituted at the stage when the best results are obtained and even the cure.
Keywords
HARADA, VKH, RETINA, UVEITIS, WIDE FIELD, STEROIDS, RETINAL DETACHMENT, COROIDE, UVEA, OCT
Area
CLINICAL CASE
Authors
ANA PAULA BORTOLOTTO, CAROLINE CORDEL RINGVELSKI, GRACE KELLY PELICIONI DE CASTRO, CARLOS AUGUSTO MOREIRA JUNIOR, CARLOS AUGUSTO MOREIRA NETO, DEBORA FISCHER, ANGELO ANTONIO DE BORBA, RAPHAEL SANTANA MIRALDI CLEMENTE