PMC3357147_01
a, b Fundus photography of optic disc swelling and serous retinal detachment in both eyes of Case 1 before treatment. c, d FA showing remarkable dye staining of the optic disc and subretinal dye pooling in both eyes in the late phase. e, f SD-OCT showing remarkable choroidal folds and serous retinal detachment in both eyes.
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F1
Funduscopic examination revealed optic disc swelling and serous retinal detachment in both eyes (fig. 1a, b). Fluorescein angiography (FA) revealed remarkable leakage of the dye from the optic disc and retina in both eyes in the early phase, and subretinal dye pooling in both eyes was observed in the late phase (fig. 1c, d). Tokyo, Japan) revealed remarkable choroidal folds and serous retinal detachment in both eyes (fig. 1e, f). The patient also complained of headache and tinnitus.
Doses of methylprednisolone and treatment course of Case 1. Day 1 indicates the first day on which steroids were administered. On day 105, choroidal folds were detected by OCT. On day 154, serous retinal detachment was detected by OCT. Steroid pulse therapy was initiated again.
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F2
SD-OCT findings. Steroid pulse therapy consisting of 1,000 mg methylprednisolone was intravenously administered for 3 days, followed by oral steroid tapering (fig. 2).
OCT images of Case 1. a Choroidal folds rapidly disappeared and the amount of serous retinal detachment was reduced remarkably on day 13 after the initiation of steroid therapy. b Choroidal folds re-formed on day 105. c Serous retinal detachment appeared in the left eye and choroidal folds were enhanced on day 154.
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F3
OCT image showing serous retinal detachment (fig. 3c). OCT detected choroidal folds 2 months before the emergence of serous retinal detachment (fig. 3b).
PMC3357147_02
a, b Fundus photography showing serous retinal detachment in both eyes of Case 2 before treatment. c, d SD-OCT showing choroidal folds and serous retinal detachment with the presence of subretinal septa before treatment. e, f SD-OCT images showing choroidal fold formation on day 63 after the initiation of steroid therapy.
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F4
Funduscopic examination revealed serous retinal detachment in both eyes without optic disc swelling (fig. 4a, b). SD-OCT showed remarkable choroidal folds and mutilobular serous retinal detachment in both eyes with the presence of subretinal septa (fig. 4c, d). At the time of recurrence, choroidal folds were detected by OCT and funduscopic examination, and the patient again started complaining of metamorphopsia (fig. 4e, f).
Doses of methylprednisolone and treatment course of Case 2. Day 1 indicates the first day on which steroids were administered. On day 63, choroidal folds were detected by OCT and funduscopic examination. On day 64, the steroid was increased to 40 mg/day.
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F5
After VKH diagnosis, systemic steroid therapy consisting of 250 mg methylprednisolone was initiated and tapered (fig. 5).