Poster 2 Ana Isabel Pastor Vivas

We report a 46-year-old Pakistani woman who came to the emergency for a large decrease in visual acuity in her right eye, a few days earlier. She also had feeling of malaise, and headache with right predominance. The patient reported a similar episode in her left eye for years, with good resolution after treatment. She did not provide any reports of this. Visual acuity was counting fingers in the right eye and 1.0 in the left eye. In addition, we observed a relative afferent pupillary defect in the right eye, along with a fundus image of papillitis, hypopigmented lesions and neurosensory detachment affecting the entire posterior pole. In the left eye we found pigmented lesions without signs of activity, with a normal appearance of the macula and optic nerve. All the study conducted, included serology, Mantoux, chest radiography and MRI brain were normal. Suspecting Vogt Koyanagi Harada syndrome we treated the patient with oral corticosteroids over three and a half months, with a significant improvement of the condition. Two months after the end of treatment the patient’s visual acuity was 0.9 and the pupillary defect was gone, like the papillitis and neurosensory detachment. With this case we want to highlight the striking improvement in Vogt Koyanagi Harada syndrome with the early introduction of corticosteroid treatment.