Skip to main content

Advertisement

SpringerLink
Log in

Annular choroidal detachment in a patient with Vogt–Koyanagi–Harada disease

  • Short Communication
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Background

Vogt–Koyanagi–Harada (VKH) disease is one of the diseases that show choroidal detachment. However, there are few reports about VKH disease associated with annular choroidal detachment. In this study, we describe an unusual case of VKH disease with an annular choroidal detachment and absence of a serous retinal detachment.

Methods

The study was an interventional case report. A 59-year-old Japanese woman presented with bilateral blurred vision with meningismus. Laboratory and clinical investigations were performed, including fluorescein angiography, B-scan echography, computed tomography scans, magnetic resonance imaging, cerebrospinal fluid examination, and blood examination including HLA typing . After a diagnosis of VKH disease was made, the patient was treated with systemic corticosteroids.

Results

The patient had iridocyclitis, optic disc swelling, choroidal thickening, and annular choroidal detachment in both eyes. Ophthalmoscopic examination did not reveal an obvious serous retinal detachment. Fluorescein angiography showed prominent leakage of dye from the optic disc and mild dye pooling in the subretinal space. The sclera was not thickened, and the axial lengths were relatively short. The findings were bilateral and symmetrical. Cerebrospinal fluid pleocytosis and HLA typing were consistent with VKH disease. After systemic corticosteroid treatment, the abnormal findings were resolved. Neither sunset glow fundus nor cutaneous lesions were observed, and no recurrences were observed during 4 years of follow-up.

Conclusion

The annular choroidal detachment was probably caused by severe choroidal inflammation and resistance to scleral outflow because of the scleral abnormality due to inflammation and short axial length. We believe that intact and functioning retinal pigment epithelium prevented serous retinal detachment. This case reports annular choroidal detachment without retinal detachment associated with VKH diseases.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1a,b
Fig. 2
Fig. 3
Fig. 4

References

  1. Bouchenaki N, Herbort CP (2001) The contribution of indocyanine green angiography to the appraisal and management of Vogt–Koyanagi–Harada disease. Ophthalmology 108:54–64

    Article  CAS  PubMed  Google Scholar 

  2. Brockhurst RJ, Maguire AM (2001) Ciliochoroidal (uveal) effusion. In: Ryan SJ (ed) Retina, 3rd edn., vol.II, Mosby, St. Louis , chap 110

  3. Foster CS, de la Maza MS (1994) The sclera. Springer, Berlin Heidelberg New Yorkpp 95–136

  4. Inomata H (1999) Vogt–Koyanagi–Harada syndrome. In: Yanoff M, Duker JS (eds) Ophthalmology. Mosby, London, chap 19

  5. Ishihara A, Totsuka S (1985) A case of Harada’s disease with shallow anterior chamber and choroidal detachment [in Japanese]. Folia Ophthalmol Jpn 36:1281–5

    Google Scholar 

  6. Johnson MW (1999) Uveal effusion. In: Guyer DR, Yannuzzi LA, Chang S, et al (eds) Retina,vitreous, macula. Saunders, Philadelphia, chap 56

  7. Kishi A, Nao-i N, Sawada A(1996) Ultrasound biomicroscopic findings of acute angle-closure glaucoma in Vogt–Koyanagi–Harada syndrome. Am J Ophthalmol 122:735–7

    CAS  PubMed  Google Scholar 

  8. Kohno T, Miki T, Shiraki K, et al (1999) Subtraction ICG angiography in Harada’s disease. Br J Ophthalmol 83:822–33

    CAS  PubMed  Google Scholar 

  9. Lyon AT, Jampol LM (1999) Posterior scleritis. In: Guyer DR, Yannuzzi LA, Chang S, et al (eds) Retina,vitreous, macula. Saunders, Philadelphia, chap 54

  10. Majima A (1994) Microphthalmos and its pathogenic classification [in Japanese]. J Jpn Ophthalmol Soc 98:1180–200

    CAS  Google Scholar 

  11. Maruyama Y, Kimura Y, Kishi S, et al (1998) Serous detachment of the ciliary body in Harada disease. Am J Ophthalmol 125:666–72

    Article  CAS  PubMed  Google Scholar 

  12. Miller NR (1998) Papilledema. In: Miller NR, Newman NJ (eds) Walsh and Hoyt’s clinical neuro-ophthalmology, 5th edn., vol.I. Williams & Wilkins, Baltimore, chap 10

  13. Miyazaki T, Ishizu M (1993) A case of Harada’s disease with choroidal detachment [in Japanese]. Folia Ophthalmol Jpn 44:766–71

    Google Scholar 

  14. Moothy RS, Rao NA (1999) Noninfectious chorioretinal inflammatory conditions. In: Regillo CD, Brown GC, Flynn HW Jr (eds) Vitreoretinal disease: the essentials. Thieme, New York, chap 26

  15. Nussenblatt RB (2001) Vogt–Koyanagi–Harada syndrome (uveomeningitic syndrome). In: Ryan SJ (ed) Retina, 3rd edn., vol.II, Mosby, St. Louis, chap 109

  16. Rao NA, Inomata H, Moorthy RS (1996) Vogt–Koyanagi–Harada syndrome. In: Pepose JS, Holland GN, Wilhelmus KR (eds) Ocular infection and immunity. Mosby, St. Louis, chap 58

  17. Read RW, Holland GN, Rao NA, et al (2001) Revised diagnostic criteria for Vogt–Koyanagi–Harada disease: report of an international committee on nomenclature. Am J Ophthalmol 131:647–52

    CAS  PubMed  Google Scholar 

  18. Rubsamen PE, Gass JDM (1999) Vogt–Koyanagi–Harada syndrome. In: Guyer DR, Yannuzzi LA, Chang S, et al (eds) Retina,vitreous, macula. Saunders, Philadelphia, chap 47

  19. Sabti K, Lindley SK, Mansour M (2001) Uveal effusion after cataract surgery: an echographic study. Ophthalmology 108:100–3

    Article  CAS  PubMed  Google Scholar 

  20. Spaide RF, Yannuzzi LA (1998) Manifestations and pathophysiology of serous detachment of the retinal pigment epithelium and retina. In: Marmor MF, Wolfensberger TJ (eds) The retinal pigment epithelium: function and disease. Oxford University Press, New York, chap 22

  21. Uematsu M, Kawashima H, Yamagami S, et al (1997) Massive corticosteroid therapy was effective in two cases of Harada disease with prominent choroidal detachment [in Japanese]. Jpn J Clin Ophthalmol 51:1625–9

    Google Scholar 

  22. Uyama M, Takahashi K, Kozaki J, et al (2000) Uveal effusion syndrome: clinical features, surgical treatment, histologic examination of the sclera, and pathophysiology. Ophthalmology 107:441–9

    Article  CAS  PubMed  Google Scholar 

  23. Yoshioka K, Onoe S (1995) A case of Harada’s disease with choroidal detachment [in Japanese]. Jpn Rev Clin Ophthalmol 89:1400–3

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Yamamoto Eye Clinic, 8-19 Yaotomi-cho, 443-0055 , Gamagori-shi, Aichi-ken, Japan

    Noriaki Yamamoto

  2. Department of Ophthalmology, Gamagori City Hospital, Gamagori, Japan

    Kengo Naito

Authors
  1. Noriaki Yamamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kengo Naito
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Noriaki Yamamoto.

Additional information

The authors have no financial interests in the products or devices mentioned in this study

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yamamoto, N., Naito, K. Annular choroidal detachment in a patient with Vogt–Koyanagi–Harada disease. Graefe's Arch Clin Exp Ophthalmol 242, 355–358 (2004). https://doi.org/10.1007/s00417-003-0832-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-003-0832-4

Keywords

Search

Navigation