Treatment of Vogt-Koyanagi-Harada Disease

Vogt-Koyanagi-Harada (VKH) disease is a T-cell-mediated autoimmune inflammatory disease characterized by granulomatous panuveitis with a variety of other systemic manifestations. A 29-year-old man referred with a two-week history of pain, redness, photophobia, and blurring of vision of the right eye. The patient reported a history of tinnitus and vertigo. Ocular examination revealed that the visual acuity was hand movement oculus dextrus (OD) and 1.0 oculus sinister (OS), slight periocular depigmentation in the right eye, iris bombe in the right eye, sunset glow sign similar to Dalen-Fuchs nodules of multifocal choroiditis in the right eye, reduced fovea reflex/subtle macular edema in the right eye, and normal anterior and posterior segment OS. The patient underwent a series of investigations and treatments, including corticosteroids, cyclosporine, antibiotics, and other local eye drugs. Surgical treatment included scheduling intravitreal ranibizumab for the right eye. Outcomes included improved general health conditions and improved visual condition (visual acuity improved to 0.8 OD). The combined therapy of immunosuppressive drugs with steroids was effective in improving visual impairment.

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