Vogt-Koyanagi-Harada disease presenting secondary to a post-infectious autoimmune response.

PURPOSE

To report a rare case of Vogt-Koyanagi-Harada disease likely secondary to post-infectious autoimmune response in a 14-year-old Hispanic female.

OBSERVATIONS

On presentation, visual acuity was 20/400 in the right eye and 20/20 in the left eye. The patient also had bilateral hyperemia, subretinal fluid, and vitreous cell graded at 1+. Fluorescein angiography and indocyanine green chorioangiography showed bilateral peripapillary hypofluorescence consistent with blocking and hyperflourescence consistent with staining. Laboratory testing showed elevated IgM and rising IgG antibodies. Topical steroids and oral steroids helped mitigate the systemic disease process and fully restore visual acuity through the 7-week mark.

CONCLUSIONS AND IMPORTANCE

The patient had elevated IgM and rising IgG antibodies resulting in ocular inflammation likely secondary to an autoimmune response. In this case of post-infectious , topical corticosteroids were beneficial in mitigating ocular manifestations initially, although oral steroids were needed and tapered over 6 weeks.