PMC8789872_01
Acute angle-closure glaucoma secondary to Vogt-Koyanagi-Harada disease at initial visit. Ultrasound biomicroscopy revealed both leakage (red arrow) and forward rotation of the ciliary body and secondary angle-closure in bilateral eyes [(A) right eye, (B) left eye]. Color fundus photograph showed multifocal serous retinal detachments with hyperaemic optic discs in both eyes [(C) right eye, (D) left eye]. Typical "multiple lake" hyperfluorescence and optic disc leakage are found in the late stage of fundus fluorescein angiography [(E) right eye, (F) left eye].
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F1
Moreover, ultrasound biomicroscopy (UBM) revealed shallow anterior chambers (central anterior chamber depth of 1.75 mm in the right eye and 1.85 mm in the left eye) and angle closure in both eyes (Figure 1). Moreover, typical "multiple lake" hyperfluorescence and optic disc leakage in the late phase were also observed via fundus fluorescein angiography (Figure 1).
Increased subretinal fluid after initial corticosteroid therapy. (A,B) Optical coherence tomography (OCT) showing multifocal serous retinal detachments with choroidal effusion in both eyes (left illustrations indicate the orientation of OCT scanning profile). (C,D) Subretinal fluid (SRF) increased and the coalescence of previous multifocal serous retinal detachments was observed in both eyes after initial corticosteroid therapy [left illustrations indicate the orientation of OCT scanning profile, and point-to-point follow-up mode was used for (A,C), (B,D)]. (E,F) OCT showing complete absorption of SRF with normal macular structure 6 months after the onset of Vogt-Koyanagi-Harada disease [left illustrations indicate the orientation of OCT scanning profile, and point-to-point follow-up mode was used for (A,E), (B,F)].
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In addition, optical coherence tomography (OCT) revealed multifocal serous retinal detachments with choroidal effusion in both eyes (Figure 2), also confirmed by ocular B ultrasonography. After the administration of 105 mg prednisone once a day for 1 week, the IOPs of the right and left eye increased to 23 and 26 mmHg, respectively, with the aggravation of the serous retinal detachment (Figure 2). Six months after the onset of VKH, normal macular structures were obtained with the complete absorption of SRF (Figure 2).
Recovery from Vogt-Koyanagi-Harada disease. (A,B) The fundus appears normal in the right and left eyes, respectively, after systemic corticosteroid therapy. (C,D) Optical coherence tomography angiography still shows bilateral dotted hypoperfusion of the choroidal capillaries [red arrows; (C): right eye; (D): left eye] 6 months after the onset of Vogt-Koyanagi-Harada disease.
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However, at this stage, dotted hypoperfusion of choroidal capillaries can still be observed in OCT angiography (Figure 3).