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Vogt-Koyanagi Harada Disease
Fernando Oréfice Juliana Lambert Oréfice Centro Brasileiro de Ciências Visuais- Brazil
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Ocular History 31 year woman Sudden blurred vision from 2 days prior
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First Presentation VA: OD 20/200, OS 20/400 Mild AC cell 1+/4+ Fundus:
Hyperaemia of disc Exudative retinal detachment
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Serous detachment Hyperemia disk
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Spectral OCT Serous detachment Serous detachment
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Spectral OCT Posterior retinal irregular profile.
Macular serous detachment
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Fundus fluorescein angiography
OD: disc hyperfluorescence OS pinpoint
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Diagnosis Vogt-Koyangi Harada Disease Involvement of the optic nerve
very significant justifies a more aggressive treatment.
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Treatment Intravenous methyprednisolone 250mg IV, 6/6 hours, 3 days
followed by oral prednisone
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Follow up - Week 9 VA: OD 20/20, OS 20/20 AC cell 0+/4+
Oral prednisolone
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Follow up Week 9
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Follow up Week 9
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Follow up Week 9 OD: Baseline: Disc hyperfluorescence
Week 09: Normal fundus fluorescein OS: Baseline: Macular pinpoint
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Follow up Week 9 Serous detachment RPE line was reformed
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Follow up Week 9 Serous detachment
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Follow up Week 9 OCT Baseline: Macular serous detachment.
Week 9: RPE line was reformed
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Conclusion Early and aggressive high-dose systemic corticosteroid therapy has become the mainstay therapy of VKH disease. Quick answer to the treatment Patients with VKH disease adequately treated with corticosteroids have a favorable visual prognosis.
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