Abstracts
Atypical manifestations of Vogt-Koyanagi-Harada syndrome
John SS, Jasper S, Antony J, Porwal S, Kuriakose T
Author Affiliations
Christian Medical College, Vellore, India
Correspondence: Dr. Sheeja Susan John
IJIR. 2020;(4)1:A3
Submitted: 30 January 2020, Published: 18 February 2020
© IJIR
Abstract
Introduction: Atypical manifestations and complications of Vogt-Koyanagi-Harada syndrome can present a clinical challenge. We report three cases of probable Vogt-Koyanagi-Harada syndrome with atypical manifestations.
Methods: Retrospective analysis of medical records of three patients with probable Vogt-Koyanagi-Harada syndrome, seen in the uveitis clinic of a tertiary care institution in South India.
Results: Case 1 was a 53-year-old lady who presented with bilateral acute angle closure glaucoma, associated with choroidal thickening and exudative retinal detachment. The patient responded to treatment with intravenous methyl prednisolone, followed by oral steroids and azathioprine. Case 2 was a 71-year-old man who had achieved adequate control of inflammation with steroids and azathioprine. He presented with bilateral anterior ischemic optic neuropathy, associated with reactivation of ocular inflammation with severe disc edema, after being lost to follow up, and abruptly stopping oral steroids. Case 3 was a 31-year-old pregnant lady, who had achieved good control of inflammation with systemic steroids. However, persistent, residual edema was noted in both the optic discs. She presented with neovascularization of the optic disc in both eyes, associated with mild reactivation of ocular inflammation, on tapering steroids.
Conclusion: Clinicians should be aware of atypical presentations and complications of Vogt-Koyanagi-Harada syndrome, so that prompt and appropriate management can be initiated to prevent irreversible visual loss.