A case of refractory Vogt-Koyanagi-Harada disease treated with local injection of triamcinolone acetonide Hiroaki Kato 1 , Katsuya Yamazoe 1 , Kazuki Hotta 1 1Department of Ophthalmology, Kameda Medical Center pp.1251-1257
Published Date 2017/8/15
DOI https://doi.org/10.11477/mf.1410212375
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Abstract Purpose:To report a case of recurrent and refractory Vogt-Koyanagi-Harada(VKH)disease that responded to local injection of triamcinolone.

Case:A 62-year-old male presented with poor visual acuity in both eyes since one month before.

Findings and Clinical Course:Corrected visual acuity was 0.3 right and 0.2 left. Both eyes showed signs of inflammation in the anterior chamber. Both eyes showed disc swelling and serous retinal detachment. Under the diagnosis of VKH disease, he was treated by pulsed corticosteroid therapy. Disc swelling and retinal detachment subsided in both eyes. Retinal detachment recurred in the left eye 5 months later. Pulsed steroid therapy was futile. Treatment with peroral corticosteroid was followed by septicemia. After reduction in dosage of corticosteroid, the left eye received subtenon injection of triamcinolone. Retinal detachment in the left eye disappeared. Retinal detachment recurred another 5 months later, but was controlled after intravitreal and subtenon injection of triamcinolone. Due to persistent fibrinization of subretinal exudate, visual acuity remained 1.0 right and 0.1 left for 4 years until present.

Conclusion:Topical injection of triamcinolone was effective for recurrent and refractory VKH disease.

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