A 52-year-old female that presents with blurry vision and eye pain for 2 days. VA OD E at 6' and OS 20/400. AC trace cell. Vit 1+ cell. DFE and OCT showed swollen optic disc and bilateral serous retinal detachments. Most likely diagnosis for bilateral panuveitis with serous retinal detachments in a patient without history of trauma in this patient population is VKH. Sarcoidosis, lymphoma, syphilis and TB are also on the differential. Once infectious labs were negative, pt was started on oral prednisone and responded well with significant improvement in VA. Due to side effects, pt was transitioned to methotrexate and VA has improved significantly. Pt had episode of decreased VA and recurrence of inflammation at 10month follow up. Therefore, adalimumab was added. This presentation explores IMT as a first line treatment in addition to steroids, possible therapeutic window in VKH and the use of ICGA to guide therapy duration in VKH.
Presentation Date: 10/17/2019
Issue Date: 08/01/2020