Zhou Zhenbao, Zhao Liying, Liu YuHuan, Zhuo Nan, Chen Han, Wang ShouBi, Yang YuYi, Wang LiBo, Zhou XiangRu
Department of Ophthalmology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
Department of Ophthalmology, HongQi Hospital, MuDanJiang Medical University, China.
Heliyon. 2024 Oct 10;10(20):e38897. doi: 10.1016/j.heliyon.2024.e38897. eCollection 2024 Oct 30.
To report a rare case of Vogt-Koyanagi-Harada (VKH) disease complicated by unilateral focal choroidal excavation (FCE).
A 25-year-old male patient with bilateral blurred vision, tinnitus, and headache. Initial examination revealed multiple sensory retinal detachments in both eyes. Optical coherence tomography (OCT), fundus fluorescein angiography (FFA), and other diagnostic tests confirmed VKH. The patient was treated with intravenous methylprednisolone followed by oral prednisolone.
Following treatment, the exudative retinal detachments resolved, and a subfoveal FCE was observed in the right eye. OCT imaging revealed choroidal inflammation and retinal pigment epithelium (RPE) disruption. The patient's visual acuity improved, but the FCE persisted during follow-up, suggesting a potential association between inflammation and the development of FCE in VKH.
This case highlights the rare occurrence of FCE during the course of VKH disease, suggesting that inflammatory disruption of the RPE and choroidal atrophy may contribute to FCE formation. Comprehensive retinal imaging in VKH patients is essential for detecting such complications, which may influence long-term visual outcomes. This case adds to the limited literature on the relationship between ocular inflammation and choroidal excavation, providing valuable insights for future clinical management.
报告一例罕见的Vogt-小柳-原田（VKH）病合并单侧黄斑区脉络膜缺损（FCE）的病例。
一名25岁男性患者，双眼视力模糊、耳鸣且头痛。初始检查发现双眼多处感觉性视网膜脱离。光学相干断层扫描（OCT）、眼底荧光血管造影（FFA）及其他诊断检查确诊为VKH。患者接受静脉注射甲泼尼龙治疗，随后口服泼尼松龙。
治疗后，渗出性视网膜脱离消退，右眼黄斑区出现FCE。OCT成像显示脉络膜炎症和视网膜色素上皮（RPE）破坏。患者视力改善，但随访期间FCE持续存在，提示VKH炎症与FCE发生之间可能存在关联。
该病例突出了VKH病病程中FCE的罕见发生，提示RPE的炎性破坏和脉络膜萎缩可能导致FCE形成。对VKH患者进行全面的视网膜成像对于检测此类并发症至关重要，因为这些并发症可能影响长期视觉预后。该病例补充了关于眼部炎症与脉络膜缺损关系的有限文献，为未来临床管理提供了有价值的见解。
