scholarly journals Juvenile Vogt-Koyanagi-Harada Disease in Which Good Visual Prognosis Was Derived from Swift and Definitive Diagnosis

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Atsushi Yoshida ◽  
Satoko Tominaga ◽  
Hidetoshi Kawashima
Keyword(s):  
Cerebrospinal Fluid ◽  
Retinal Detachment ◽  
Anterior Chamber ◽  
Serous Retinal Detachment ◽  
Subretinal Fluid ◽  
Definitive Diagnosis ◽  
Conjunctival Hyperemia ◽  
Visual Prognosis ◽  
Cerebrospinal Fluid Examination ◽  
Vkh Disease

We report an 8-year-old girl who manifested Vogt-Koyanagi-Harada (VKH) disease. At the first visit, conjunctival hyperemia, inflammation in the anterior chamber, serous retinal detachment, and papillitis were observed in both eyes. Fluorescein angiography (FA) revealed bilateral subretinal fluid and papillitis. Ocular computed tomography (OCT) showed subretinal fluid and choroidal hypertrophy underneath macula in both eyes. Cerebrospinal fluid examination indicated aseptic meningitis. Systemic data did not suggest the other systemic diseases. Therefore, she was diagnosed with incomplete VKH disease. After corticosteroid pulse therapy, oral prednisolone was administered for seven months. Eighteen days after the induction of the treatments, inflammation in the anterior chamber and serous retinal detachment of both eyes disappeared completely. For seven months after the induction of the treatments, she had no relapses of any symptoms. Cerebrospinal fluid examination and FA for children are difficult to conduct, since it is difficult to get informed consent of these examinations from their parents. However, those thorough examinations enable us to make a swift and definitive diagnosis of VKH disease, thus assuring good visual prognosis. We have to bear in mind that juvenile VKH disease is very rare, yet when it occurs, ophthalmologic examinations help us diagnose and treat it.

scholarly journals Unilateral Vogt-Koyanagi-Harada Disease: A Clinical Case Report

2015 ◽  
Vol 6 (3) ◽  
pp. 361-365 ◽  
Author(s):  
Arminda Neves ◽  
Ana Cardoso ◽  
Mariana Almeida ◽  
Joana Campos ◽  
António Campos ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Retinal Detachment ◽  
Serous Retinal Detachment ◽  
Subretinal Fluid ◽  
Posterior Pole ◽  
Exudative Retinal Detachment ◽  
The Right ◽  
Clinical Records ◽  
Vkh Disease

Purpose: To report a case of a 20-year-old female with decreased visual acuity (VA) in the left eye (LE). Methods: This is a retrospective and descriptive case report based on data from clinical records, patient observation and analysis of diagnostic tests. Results: A 20-year-old female presented with decreased VA in the LE for 3 days. Best-corrected visual acuity (BCVA) was 20/20 in the right eye (RE) and 20/40 in the LE. Pupillary function, intraocular pressure, results of external segment examinations and slit-lamp biomicroscopy were normal, bilaterally. RE fundoscopy was normal, and in the LE it revealed papillitis and posterior pole exudative retinal detachment. Optical coherence tomography (OCT) confirmed the macular serous retinal detachment and showed thickening of the posterior choroid also revealed by orbital ultrasound and magnetic resonance imaging (MRI). Fluorescein angiography showed angiographic features typical of Vogt-Koyanagi-Harada (VKH) disease: disseminated spotted choroidal hyperfluorescence and choroidal multifocal hypofluorescence, multifocal profuse leakage in the retina with pooling, serous retinal detachment and optic disc hyperfluorescence. Serological testing for the diagnosis of infectious pathologies was negative, and the review of systems was normal. The patient received systemic steroids and cyclosporine. LE BCVA improved up to 20/20 at 18 months after the diagnosis, with complete reabsorption of subretinal fluid and normal retinal and choroidal thickness by OCT. Conclusion: Despite the unilateral involvement, the clinical and angiographic features were typical of VKH disease, and ophthalmologists should be aware to recognize this rare clinical variant of the disease.

scholarly journals Acute Posterior Multifocal Placoid Pigment Epitheliopathy Sharing Characteristic OCT Findings of Vogt-Koyanagi-Harada Disease

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Yuta Kitamura ◽  
Toshiyuki Oshitari ◽  
Masayasu Kitahashi ◽  
Takayuki Baba ◽  
Shuichi Yamamoto
Keyword(s):  
Retinal Detachment ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Late Phase ◽  
Serous Retinal Detachment ◽  
Subretinal Fluid ◽  
Hla Typing ◽  
Blurred Vision ◽  
Fluid Analysis ◽  
Vkh Disease

A 17-year-old male presented with acute bilateral paracentral scotomata and blurred vision. Funduscopic examination showed bilateral macular serous retinal detachment and yellow-white placoid lesions at the level of retinal pigment epithelium. OCT study showed typical VKH disease findings with marked choroidal thickening and macular serous retinal detachment partly with subretinal septa in both eyes. FA demonstrated hypofluorescence at the placoid lesions in the early phase and hyperfluorescence in the late phase. Laboratory investigation showed negative result for HLA-DR4 serotype and the patient’s cerebrospinal fluid test values were within normal range. We made the diagnosis of APMPPE from these results. At 2-month follow-up without the use of corticosteroids, OCT reexamination showed complete amelioration of subretinal fluid in both eyes. Patchy pigmentary lesions also resolved clinically with partial chorioretinal scars. The results in this case suggested OCT findings in APMPPE patients could be similar to characteristic features usually found in acute VKH disease. We recommend comprehensive assessments such as FA, cerebral spinal fluid analysis, and HLA typing which help in leading proper diagnosis.

scholarly journals Unusual Case of Vogt-Koyanagi-Harada Disease Associated with SAPHO Syndrome: A Case Report

2018 ◽  
Vol 9 (1) ◽  
pp. 202-208 ◽  
Author(s):  
Miyuki Hasegawa ◽  
Akira Fukutomi ◽  
Akiko Jinno ◽  
Kyoko Fujita ◽  
Motohiro Kamei
Keyword(s):  
Retinal Detachment ◽  
Anterior Chamber ◽  
Past History ◽  
Retinal Pigment ◽  
Serous Retinal Detachment ◽  
Sapho Syndrome ◽  
Systemic Steroid ◽  
High Dose ◽  
Eye Drops ◽  
Vkh Disease

A 66-year-old Japanese woman who was diagnosed with synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome presented with bilateral blurred vision 4 months prior to visiting our hospital. She had visited a local ophthalmology clinic first. She was diagnosed with conjunctivitis and was prescribed antibacterial eye drops. The symptoms persisted in spite of treatment. She was then referred to our hospital. At her initial visit, the visual acuities were 0.6 in both eyes. A slit-lamp examination revealed bilateral shallow anterior chamber, and intraocular pressures of 18 mm Hg in the right eye and 16 mm Hg in the left eye. There were no cells in the anterior chamber. Fundus examination revealed bilateral annular choroidal detachment and serous retinal detachment. Fluorescein angiography showed leakage of dye from the retinal pigment epithelium (RPE) and indocyanine green angiography showed focal choroidal hypoperfusion. Optical coherence tomography showed wavy RPE line and blurry thick choroid. Systemic investigation by the physician demonstrated bilateral pleural effusions of unknown origin. The patient had a past history of breast cancer; however, no metastasis was identified via malignant cells through cytology, laboratory findings, radiographs, CT, and MRI. After the diagnosis of Vogt-Koyanagi-Harada (VKH) disease was made, the patient was treated with local and systemic steroid including high-dose intravenous corticosteroids, and 150 mg of cyclosporine per day. Seventy days after the second high-dose of intravenous corticosteroids, these medications brought a complete resolution of both choroidal and retinal detachment. VKH disease associated with SAPHO syndrome is rare. The combination of immunosuppressive drug and steroid might be helpful for severe cases of VKH disease.

Persistent Subretinal Fluid Mimicking Central Serous Retinopathy after Scleral Buckling Surgery: Possible Vortex Vein Compression Role

2017 ◽  
Vol 27 (2) ◽  
pp. e54-e56 ◽  
Author(s):  
Chiara Giuffrè ◽  
Adriano Carnevali ◽  
Marco Codenotti ◽  
Eleonora Corbelli ◽  
Luigi A. De Vitis ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Indocyanine Green Angiography ◽  
Serous Retinal Detachment ◽  
Subretinal Fluid ◽  
Scleral Buckling ◽  
Central Serous Retinopathy ◽  
Retinal Detachment Surgery ◽  
Encircling Band ◽  
Vortex Vein ◽  
Sd Oct

Purpose To describe the case of a woman who developed persistent subretinal fluid in the macular region after the placement of encircling band for retinal detachment surgery, possibly due to vortex vein compression. Methods Case report. Results A 66-year-old woman diagnosed with central serous retinopathy presented with poor vision and metamorphopsia in the left eye (LE). Her visual acuity had deteriorated to 20/100 in LE after retinal detachment surgery with scleral buckling 8 months before. Multimodal imaging including fundus autofluorescence and fluorescein angiography disclosed a gravitational hyperfluorescent area involving the macular region that appeared to originate from the superotemporal quadrant in correspondence with the buckling. This area corresponded to a serous retinal detachment on structural spectral-domain optical coherence tomography (SD-OCT). Interestingly, on indocyanine green angiography, the encircling band of the scleral buckling appeared located at the emergence of the superotemporal vortex vein. Based on these findings, the patient was diagnosed with gravitational serous retinal detachment secondary to vortex vein compression. Successful rapid visual recovery and decrease of retinal fluid on SD-OCT was achieved with prompt surgery of scleral buckling removal, confirming the diagnosis. Conclusions Choroidal veins can be obliterated during retinal detachment surgery, especially when retinal breaks are posterior to the equator. Indocyanine green angiography is the gold standard to study choroidal circulation and in our case allowed us to visualize the compression of the superotemporal vortex vein at the site of scleral buckling.

scholarly journals Headache in a 27-year-old man: Bilateral serous retinal detachment

2011 ◽  
Vol 02 (01) ◽  
pp. 068-070
Author(s):  
Gholamhossein Yaghoubi ◽  
Behrouz Heydari ◽  
Mohammad Ali Yaghoobi
Keyword(s):  
Retinal Detachment ◽  
Normal Limit ◽  
Serous Retinal Detachment ◽  
Oral Steroid ◽  
High Dose ◽  
Ocular Symptoms ◽  
Dose Oral ◽  
Prescribed Medicines ◽  
Vkh Disease ◽  
Probable Diagnosis

ABSTRACTA 27-year-old man with a complaint of headache, tinnitus, and visual obscuration presented to a neurologist. Neurologic evaluations, including MRI and CT scan, were within normal limit. The prescribed medicines were propranolol, sumatriptin, valproate sodium, and dexamethasone. Ophthalmic examination was associated with reduction of visual acuity of eyes, bilateral uveitis, and serous retinal detachment. The most probable diagnosis was Vogt–Koyanagi–Harada (VKH) disease. Prescribing high-dose oral steroid and acetazolamide-improved systemic and ocular symptoms. Although HLAB5 is positive in Behçet disease, it also may be seen in VKH.

scholarly journals Spontaneous Closure of the Macular Hole in a Patient with Acquired Vitelliform Lesion

2020 ◽  
Vol 11 (1) ◽  
pp. 16-21
Author(s):  
Masanori Fukumoto ◽  
Shou Oosuka ◽  
Takaki Sato ◽  
Teruyo Kida ◽  
Tsunehiko Ikeda
Keyword(s):  
Retinal Detachment ◽  
Macular Hole ◽  
Rare Case ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Serous Retinal Detachment ◽  
Subretinal Fluid ◽  
Spontaneous Closure ◽  
Retinal Reattachment

In this paper, we report an extremely rare case of spontaneous closure of a macular hole (MH) that developed in a patient in whom acquired vitelliform lesion (AVL) occurred after vitrectomy for atopic retinal detachment (ARD). A 32-year-old male developed ARD in both eyes, and retinal reattachment was achieved after vitrectomy. Five years after surgery, optical coherence tomography showed localized serous retinal detachment (SRD) and a granular lesion with a higher brightness in the subretinal fluid, thus leading to the diagnosis of AVL. One month later, an MH developed, and a follow-up examination performed 6 weeks later revealed that the MH had spontaneously closed and the SRD decreased. In the fovea, fluorescein angiography revealed a window defect due to atrophy of the retinal pigment epithelium (RPE). These findings in this present case suggest the possibility that RPE dysfunction was involved in the development of AVL and MH.

Prevalence and causes of clinically detectable uveitic serous retinal detachment

2021 ◽  
pp. 112067212199139
Author(s):  
Robert M Kinast ◽  
Sharon D Solomon ◽  
Leo DP Cubillan ◽  
Anna Hovakimyan ◽  
Nisha Acharya ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Clinical Finding ◽  
Chart Review ◽  
Serous Retinal Detachment ◽  
Retrospective Chart Review ◽  
Intraocular Lymphoma ◽  
Posterior Scleritis ◽  
Common Cause ◽  
Toxoplasmic Retinochoroiditis ◽  
Vkh Disease

Purpose: To describe the prevalence and causes of clinically detectable uveitic serous retinal detachment (SRD). Methods: Retrospective chart review of a large clinic-based series. Results: Serous retinal detachment was present in 78 of the 2761 (2.8%) patients. Vogt-Koyanagi-Harada (VKH) disease was the most commonly identified cause (38/78, 48.7%). Less common associated etiologies included toxoplasmic retinochoroiditis (8/78, 10.3%), sarcoidosis (5/78, 6.4%), intraocular lymphoma (4/78, 5.1%), presumed tuberculosis (3/78, 3.8%), and posterior scleritis (2/78, 2.6%). Fifteen patients (19.2%) with uveitic SRD at presentation had no identifiable etiology and were labeled idiopathic or indeterminant. Thirty of the 38 patients with VKH disease (78.9%) had positive neurological and/or integumentary findings, and therefore constituted either complete or incomplete subtypes of the disease. The remaining eight (21.1%) had presumed/ocular VKH disease limited to the eye. Conclusion: While VKH disease by far is the most common cause of clinically detectable uveitic SRD, a number of other non-infectious and infectious inflammatory disorders were also associated with this distinctive clinical finding.

scholarly journals Serous Retinal Detachment Associated with Dome-Shaped Macula and Staphyloma Edge in Myopic Patients before and after Treatment with Spironolactone

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Álvaro Fernández-Vega Sanz ◽  
Carlos Mario Rangel ◽  
Eva Villota Deleu ◽  
Beatriz Fernández-Vega Sanz ◽  
Ronald Mauricio Sánchez-Ávila
Keyword(s):  
Retinal Detachment ◽  
Functional Outcomes ◽  
Retinal Thickness ◽  
Serous Retinal Detachment ◽  
Subretinal Fluid ◽  
Corrected Visual Acuity ◽  
Novel Treatment ◽  
Mineralocorticoid Antagonist ◽  
Before And After

Objective. Serous retinal detachment (SRD) is a common anatomical complication associated with dome-shaped macula (DSM) and staphyloma margin in myopic patients. Here we described the anatomical and functional outcomes obtained with the use of oral spironolactone, a mineralocorticoid antagonist, in the management of myopic patients with SRD associated with DSM and staphyloma margin.Methods. We evaluated both eyes of twelve myopic patients with long-standing SRD associated with DSM or staphyloma margin. The patients were treated daily for six months with oral spironolactone 50 mg. Best-corrected visual acuity (BCVA) and central retinal thickness (CRT), determined by optical coherence tomography, were evaluated on the first day and on monthly follow-up visits.Results. Pretreatment BCVA (mean ± standard deviation) was 0.406 ± 0.324 LogMAR, and posttreatment BCVA was 0.421 ± 0.354 LogMAR (P=0.489). Pretreatment CRT was 323.9 ± 78.6 μm, and after six months of treatment it was significantly lower, 291.2 ± 74.5 μm (P=0.010). There were no treatment-related complications.Conclusions.We evaluated a novel treatment for SRD associated with DSM and staphyloma margin in myopic patients. After six months of treatment with the mineralocorticoid antagonist spironolactone, the subretinal fluid and CRT were significantly reduced; however, there was no improvement in BCVA.

scholarly journals Exhibiting Residual Subretinal Fluid after High Myopic Macular Hole Retinal Detachment Surgery

2021 ◽  
Vol 62 (12) ◽  
pp. 1672-1678
Author(s):  
Sung Joon Kim ◽  
Jae Jung Lee ◽  
Ik Soo Byon ◽  
Ji Eun Lee ◽  
Sung Who Park
Keyword(s):  
Retinal Detachment ◽  
Macular Hole ◽  
Silicone Oil ◽  
Subretinal Fluid ◽  
Internal Limiting Membrane ◽  
Closure Rate ◽  
Visual Prognosis ◽  
Membrane Peeling ◽  
Macular Hole Retinal Detachment ◽  
The Right

Purpose: To report a case of poor visual prognosis complicated by residual subretinal fluid after use of the internal limiting membrane flap technique to treat macular hole retinal detachment in a patient with high myopia.Case summary: A 55-year-old male stated that he had experienced a transparent circle in the central visual field of the right eye for 1 month. His best-corrected visual acuity (BCVA) was 0.32 and the axial length of the right eye was 32.57 mm. Fundus examination revealed a macular hole with retinal detachment localized to the posterior pole. We performed vitrectomy, membrane peeling, internal limiting membrane peeling with inverted internal limiting membrane flap, and silicone oil injection. On day 1 after surgery, the macular hole was closed, but subretinal fluid was noticed in the macula. At 3 months after surgery, the BCVA was 0.16 and the silicone oil was removed. At 14 months after the first surgery, the subretinal fluid was completely absorbed, but leopard-pattern pigment degeneration became prominent and the macula exhibited ellipsoid zone disruption. The BCVA decreased to 0.1.Conclusions: In patients exhibiting macular hole retinal detachment in the context of high myopia, an inverted internal limiting membrane flap may increase the macular hole closure rate but disturb subretinal fluid drainage. As persistent subretinal fluid may cause permanent retinal damage with a poor visual prognosis, the surgical method must be carefully chosen.

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