PMC6489058_01
Right eye (left) and left eye (right). Vertical sections of optical coherence tomography scans before treatment. There are multiple sites of serous retinal detachment in the left eye and wavy retinal pigment epithelium in both eyes. Fluorescein angiography scans before treatment revealed multiple pinpoints of leakage in both eyes as well as active leakage from the disc in the right eye. Indocyanine green angiography also revealed choroidal hyperfluorescence due to choroidal vascular leakage, followed by hypofluorescent dark spots at a later time.
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F1
OCT; Carl Zeiss Meditec, Dublin, CA, USA) confirmed the presence of multiple sites of serous retinal detachment (SRD) in the left eye and wavy retinal pigment epithelium in both eyes (Fig. 1). On fluorescein angiography using Spectralis  HRA+OCT equipment (Heidelberg Engineering, Heidelberg, Germany), multiple pinpoint-sized areas of leakage were found in both eyes as well as active leakage from the disc in the right eye (Fig. 1). HRA+OCT revealed findings characteristic of VKH, such as choroidal hyperfluorescence due to choroidal vascular leakage and hypofluorescent dark spots during the late phase (Fig. 1). HLA typing revealed A24, B61, B48, and DR9.
Right eye (left) and left eye (right). Vertical sections of optical coherence tomography scans 4 months after treatment showed fewer serous retinal detachment sites and a reduced amount of wavy retinal pigment epithelium. Fluorescein angiography 4 months after treatment showed reduced fluorescein dye leakage. Indocyanine green angiography 4 months after treatment indicated that the multiple dark spots had almost all disappeared.
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F2
The granulomatous keratic precipitates and cells in the anterior chamber disappeared 3 weeks after starting the topical treatment, and the multiple SRDs and wavy retinal pigment epithelium gradually disappeared (Fig. 2). Fluorescein angiography showed that the multiple pinpoint-sized leakage sites in both eyes and the active leakage from the disc in the right eye had diminished (Fig. 2). IA revealed that the findings characteristic of VKH (e.g., choroidal hyperfluorescence due to choroidal vascular leakage and hypofluorescent dark spots) had also decreased (Fig. 2).
Photographs 4 months after treatment showed red depigmented fundus in both eyes.
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F3
In addition, her bilateral fundi appeared red and depigmented (Fig. 3), and her hair had lost its natural color and became grayer.