Journal List > J Korean Ophthalmol Soc > v.54(10) > 1009519

Kwak, Lim, Kim, Yun, and Lee: Vogt-Koyanagi-Harada Disease in a Pregnant Patient Successfully Treated with Intravitreal Triamcinolone Injection

Abstract

Purpose

To report a case of Vogt-Koyanagi-Harada (VKH) disease in a pregnant patient treated with intravitreal triamcinolone injection.

Case summary

A 21-year-old female in the 19th week of gestation presented with bilateral blurring of vision associated with mild headache and tinnitus. Her initial best corrected visual acuity was 0.15 in the right eye and 0.3 in the left eye. Multiple serous retinal detachment and anterior chamber inflammation were observed, and VKH disease was diagnosed. Because of her pregnancy, the patient did not want high-dose systemic prednisolone therapy which may cause an abortion or low birth weight infant when used in a pregnant patient. Therefore, an intravitreal triamcinolone (4 mg/0.1 ml) injection was given in the right eye and topical steroid eye drops were used in the left eye. After 1 day, serous retinal detachment was significantly decreased and anterior chamber inflammation disappeared in the right eye. After 1 week, no serous retinal detachment was observed. In the left eye, serous retinal detachment was decreased after using steroid eye drops. After 10 days, serous retinal detachment disappeared but anterior chamber inflammation was still observed. After 1 month, best corrected visual acuity was 1.0 in both eyes and serous retinal detachment had not recurred. On follow-up, VKH disease had not recurred and a healthy normal weight infant was delivered.

Conclusions

Intravitreal triamcinolone injection is an effective and safe treatment for VKH disease in pregnant women.

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Figure 1.
Fundus photographs and optical coherence tomography of patient at presentation (A, C: right eye; B, D: left eye).
jkos-54-1621f1.tif
Figure 2.
Serial optical coherence tomography (OCT) during follow-up period. (A) Before intravitreal triamcinolone injection and using corticosteroid eye drops. (B) One day after intravitreal triamcinolone injection to right eye. OCT shows significant reduction of serous retinal detachment. (C) Three days after treatment. In the left eye, serous retinal detachment started to decrease. (D) Ten days after treatment, relatively flat retina observed in both eyes. (E) One month after treatment. Complete resolution of serous retinal detachment. But in the left eye anterior chamber inflammationis still observed.
jkos-54-1621f2.tif
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