Figure 2 B-scan ultrasonography findings highlighting serous
retinal detachment and thickened choroid in the right eye (A) and the
left eye (B). Brain MRI images (C) demonstrating bilateral retinal
detachment.
On admission, her body temperature was 36.6 degrees Celsius (°C), and
her chest X-ray image showed no abnormal shadow. Furthermore, she was
tested by PCR and was negative for SARS-CoV-2. She did not notice
tinnitus and hair loss. A complete systemic workout was conducted with
brain magnetic resonance imaging (MRI) which demonstrated bilateral
retinal detachment, while she was negative for any optic nerve
thickening and intracranial or orbital space-occupying lesion (Figure 2
C). Complete blood tests were performed, reporting unremarkable
outcomes. Erythrocyte sedimentation rate was 20 mm/hour, and C-reactive
protein level was 0.73 mg/L. Serological tests for toxoplasmosis, EBV,
CMV, Rubella virus, Herpes simplex virus 1 and HIV were negative. In
addition, extensive blood tests for underlying autoimmune etiologies
were carried out, all within normal limits.
According to the clinical findings and laboratory data, she was
diagnosed with incomplete VKH disease, as she presented with ocular
signs and neurological findings4. Early and aggressive
systemic glucocorticosteroid (GC) therapy remain the primary treatment
according to the standard treatment for VKH disease5.
The patient was treated with pulse intravenous methylprednisolone
therapy(1000mg/day) followed by high-dose oral corticosteroid when the
diagnosis of VKH disease was made. In the clinical course of treatment,
we paid attention to deterioration of visual acuity and SRD, and tapered
the dose of prednisolone slowly. Two weeks after the first evaluation,
the patient presented with an improvement in her visual acuity, which
was 0.5 in the right eye and 0.6 in the left eye. The control OCT
fingdings revealed a significant resolution of subretinal fluid in both
eyes (Figure 3).