VOGT-KOYANAGI HARADA SYNDROME IN ITS PURELY OCULAR FORM: ABOUT A CASE

presenting a rare case of vogt-koyanagi Harada syndrome in its purely ocular form 

Ophthalmology A department, Ibn Sina hospital, Rabat, Morocco

We report the case of a 19-year-old man, with no particular pathological or traumatic history, presenting a sudden and bilateral decrease in visual acuity estimated at 20/200 in both eyes. Anterior segment evaluation revealed corneal endothelial pigment deposition in both eyes. Posterior segment examination revealed serous retinal detachments in both eyes with a hyalitis and grade I papilledema

Imaging with spectral-domain OCT (SD-OCT) showed multiple extensive serous retinal  detachments in both eyes. Fluorescein angiography revealed multifocal pinpoint leakage in the posterior pole in both eyes. The biological, infectious and immunological assessment carried out returned to normal. The diagnosis of VKH syndrome in its purely ocular form was retained. Methylprednisolone bolus corticosteroid therapy of 1 g / day for 3 days with oral relay of 1 mg/kg/ day of prednisone substituted in the third month by treatment with azathioprine. The course was marked by almost complete functional recovery in 2 months with disappearance of serous retinal detachment on angiography and persistence of a few hyperfluorescent areas corresponding to pigmentation disorder of the pigment epithelium.

VKH syndrome in its so-called possible form is rare, but the diagnosis must be made in view of the characteristic features on the fundus and on angiography with a view to early treatment on the basis of a good prognosis