This abstract is assigned to sessions
| Presentation preference | Poster presentation |
| Title | A challenging case of presumptive ocular tuberculosis with Vogt-Koyagani-Harada disease |
| Purpose | To present a seemingly clear-cut case of Vogt-Koyanagi Harada Disease (VKH) whose response to treatment was affected by a concomitant presumptive ocular tuberculosis. |
| Methods | A 69 year old Filipino female presented with a 2 week history of eye redness and sudden severe blurring of vision in both eyes with associated watery eye discharge, headache, tinnitus and vomiting. Patient complained of further worsening in vision 4 days after she was started on oral dexamethasone 1.5mg thrice daily prompting consult at our institution. |
| Results | Visual acuity was counting fingers at 3 feet in both eyes. The anterior chamber was quiet. Bullous elevations of the retina at superior, inferior arcade and macula with whitish plaque-like lesions were noted and confirmed on Optical Coherence Tomography (OCT). Papillitis, retinal vasculitis, retinal pigment epithelitis and choroiditis seen on fluorescein angiography (FA). Initial impression was Vogt-Koyonagi-Harada disease. Blood work-up prior to treatment revealed elevated C-Reactive Protein and Erythrocyte Sedimentation Rate . TB quantiferon test was positive. . Anti-Tuberculosis Treatment (ATT) was started with regression of subretinal fluid and improvement in visual acuity 4 weeks after. With residual papillitis, retinal vasculitis, retinal pigment epithelitis and choroiditis, systemic prednisone was added at 1mg/kg/day. With progression of VKH noted by poliosis and choroidal depigmentation, oral azathioprine was initiated 50mg twice daily. |
| Conclusion | This case illustrated the importance of ruling out presumptive ocular tuberculosis prior to initiating management for inflammatory uveitis. |
| Conflict of interest | No |
Authors 1
| Last name | OCAMPO |
| Initials of first name(s) | VV |
| Department | Ophthalmology |
| City | Makati City |
| Country | Philippines |
Authors 2
| Last name | Lansangan |
| Initials of first name(s) | VC |
| Department | Ophthalmology |
| City | Makati City |
| Country | Philippines |
