A Mystery of Bilateral Annular Choroidal and Exudative Retinal Detachment with No Systemic Involvement: Is It Part of Vogt-Koyanagi-Harada Disease Spectrum or a New Entity

Abstract

A 65-year-old Caucasian male presented to the eye emergency department with bilateral significant visual loss. He was otherwise healthy with no significant past medical history. Ophthalmic history was significant for chronic open-angle glaucoma, for which the patient was using latanoprost once daily to both eyes. There was no preceding history of trauma or ocular surgery and the patient was emmetropic. Two weeks prior to his presentation, he reported a headache, which settled spontaneously. Slit-lamp examination demonstrated bilateral keratic precipitates, bilateral significantly shallow anterior chamber, and bilaterally normal intraocular pressures of 16 mm Hg. Fundal examination was significant for bilateral 360-degree choroidal detachments with exudative retinal detachment involving the maculae. These findings were confirmed using wide-field fundus photography, B-scan ultrasonography, and optical coherence tomography. Fundus fluorescein angiography did not reveal any evidence of retinal vasculitis. Indocyanine green chorioangiography of the posterior pole showed multiple areas of focal choroidal hypoperfusion. Extensive systemic investigation demonstrated no infectious, neoplastic, or inflammatory cause, and the patient did not complain of any systemic symptoms. Treatment with high-dose intravenous methylprednisolone was administered and this brought about complete resolution of both choroidal and retinal detachments, with partial visual recovery.

Unusual Case of Vogt-Koyanagi-Harada Disease Associated with SAPHO Syndrome: A Case Report

“…Yamamoto and associates [ 6 ] reported a case of annular choroidal detachment without retinal detachment associated with VKH disease. Elaraoud and associates [ 7 ] reported a similar case. Our case did not manifest overt retinal detachment or disc swelling but showed multiple areas of fluorescein leakage from the RPE on FA and choroidal hypoperfusion areas on ICGA.…”

“…The ocular findings in our case, such as annular choroidal detachment, were uncommon compared to typical VKH disease. There are a few reports of VKH disease with annular choroidal detachment [ 6 , 7 ]. Yamamoto and associates [ 6 ] reported a case of annular choroidal detachment without retinal detachment associated with VKH disease.…”

Bilateral choroidal detachment and myopic shift after acetazolamide intake for laser capsulotomy

“…Fundus examination and the clinical course permitted to exclude inflammatory causes or tumours. 10 At the same time, the temporal association with acetazolamide administration makes the hypothesis of the uveal effusion syndrome unlikely.…”

Annular choroidal detachment following intravitreal aflibercept injection in a patient with nivolumab treatment: a case report

“…In this case, annular choroidal detachment developed 2 days after intravitreal anti-VEGF injection. Similar to VKH disease, patients develop choroidal detachment when there is enormous inflammation, and choroidal inflammation increases permeability of the choroidal vessels into the extravascular space [7,8].…”