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).