Internal Limiting Membrane Folds as a Presenting Sign in Acute Initial-Onset Vogt–Koyanagi–Harada Disease: A Case Report

ABSTRACT

Purpose

To report a case of initial-onset acute Vogt–Koyanagi–Harada (VKH) presenting with internal limiting membrane (ILM) folds as the initial clinical sign.

Methods

This is a retrospective case review.

Results

A 36-year-old woman with a recent history of periorbital injection of cosmetic filler who presented with sudden blurred vision in the right eye of a few hours duration. Initial fundus examination revealed only ILM folds in the right eye. Next day, the patient developed the full ophthalmic clinical picture of initial-onset acute VKH disease. Multimodal imaging showed features of ILM undulations and acute VKH disease. Uveitis was treated successfully with systemic corticosteroids combined with mycophenolate mofetil. The patient had complete resolution of posterior segment inflammation and exudative retinal detachment.

Conclusion

ILM folds/undulations can be one of the early signs in acute VKH disease, and may serve as an important early clinical clue for this diagnosis.

KEYWORDS:

• ILM folds
• VKH
• Uveitis
• Harada disease
• case report

Disclosure of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Availability of Data and Materials

The principal investigator and all co-authors had full access to all the data in the case report and take responsibility for the integrity of the data and the accuracy of the analysis.