Salim Ben Yahia*, Rim Kahloun, Bechir Jelliti, Sonia Attia, Riadh Messaoud, Moncef Khairallah (Monastir, Tunisia)

Advantages:

To report the clinical characteristics and management of serous retinal detachment secondary to acute Vogt-Koyanagi-Harada (VKH) disease.

Methods:

Retrospective chart review of 74 patients (148 eyes) diagnosed with acute VKH disease.

Effectiveness / Safety:

Serous retinal detachment was bilateral in all cases. Clinical presentation was a panuveitis in 40 patients (54%) and a posterior uveitis in 34 patients (46%). Visual acuity at presentation ranged from less than 20/200 (40.8%) to more than 20/40 (28.5%) and 30.7% were between 20/200 and 20/40. All patients were treated with systemic corticosteroids for 6 to 19 months (mean, 10.5 months). Six patients (8%) were treated with cyclosporine. Reattachment of serous retinal detachment occurred within the first three weeks. Complications included cataract in 45 eyes (31%), glaucoma in 15 eyes (10.3%), and choroidal neovascularization in 2 eyes (1.4%). Ninety eyes (62%) had final visual acuity of 20/40 or better. Factors associated with a poor visual acuity at final follow-up were the presence of a poor visual acuity at presentation, the occurrence of complications and/or recurrences.

Take home message:

Serous retinal detachment secondary to acute VKH disease should be treated with prompt and aggressive systemic corticotherapy in order to prevent evolution to severe chronic recurrent forms. Duration of treatment should be at least 6 months.