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Unusual association of diseases/symptoms
CASE REPORT
Vogt-Koyanagi-Harada syndrome presenting with bilateral optic disc swelling and leptomeningeal enhancement
  1. Thanh-Thao Adriana Le1,
  2. Sumu Simon2,
  3. Jagjit Gilhotra3 and
  4. Pravin Hissaria1,4
  1. 1 Clinical Immunology and Allergy, Royal Adelaide Hospital, Adelaide, South Australia, Australia
  2. 2 Ophthalmology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
  3. 3 South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
  4. 4 Immunology, SA Pathology, Adelaide, South Australia, Australia
  1. Correspondence to Dr Pravin Hissaria, Pravin.Hissaria{at}sa.gov.au

Abstract

Vogt-Koynagi-Harada (VKH) disease is a clinical syndrome with classical ocular and extraocular findings that is not uncommonly described in Asian, Middle-Eastern and South American populations. We describe a case of VKH in an elderly Polish-Australian distinguished by prominent bilateral disc swelling rather than uveitis and marked leptomeningeal enhancement on MRI which led to extensive investigation including brain biopsy. Both disc oedema and MRI abnormalities improved dramatically with systemic steroid therapy. VKH disease is an important differential to consider in older patients with an uveo-meningeal picture and atypical eye findings where other causes have been excluded.

  • ophthalmology
  • neuroopthalmology
  • neuroimaging
  • immunology

https://doi.org/10.1136/bcr-2019-229719

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    Footnotes

    • Contributors All authors listed made substantial contributions: T-TAL—drafting of manuscript. SS—acquisition of images; analysis and interpretation of data; revising of the work. JG—acquisition of images; analysis and interpretation of data. PH— conception of the work; analysis and interpretation of data; revising of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Obtained.