[Two cases of subretinal neovascular membrane in Vogt-Koyanagi-Harada syndrome].
OBJECTIVE
To report two cases of Vogt-Koyanagi-Harada syndrome (VKH) complicated by subretinal neovascularization.


METHODS
The first patient was a 12-year-old girl in whom choroidal neovascularization occurred after VKH had evolved for 9 months. Fundus examination of the left eye revealed a macular extrafoveolar superior serous retinal detachment (SRD) centered by a grey-white pseudo-tumoral zone. A crown of exudates lined the SRD. Pigment epithelium impairment was substantial. Fluorescein angiography showed an early intensive and diffuse staining in the left eye corresponding to a neovascular membrane associated with a late impregnation of the SRD. Green monochromatic laser photocoagulation was considered but refused by the parents. The second patient was an 18-year-old girl followed up for VKH for 2 years. Ophthalmoscopy showed a serous retinal detachment with hemorrhage and hard exudates in the right eye. Fluorescein angiography showed early staining in the juxtapapillary region corresponding to a juxtapapillary neovascular membrane. High-dose systemic corticotherapy was instituted. Photocoagulation was not indicated because of the juxtapapillary topography of the neovascular membrane.


CONCLUSIONS
VKH is a bilateral panuveitis that can be complicated by subretinal neovascularization in 2.5%-10% of cases. This complication must be diagnosed early. We discuss angiogenic factors and therapeutic modalities.
Ketata
A
A
Service d'Ophtalmologie, CHU Habib Bourguiba, Sfax, Tunisia.
Ben Zina
Z
Z
Hajji
D
D
Sellami
D
D
Abdelkefi
A
A
Kharrat
W
W
Bouaouaja
G
G
Dabbeche
K
K
Feki
J
J
D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D015861:Retinal Neovascularization / Q000209:etiology*; D014607:Uveomeningoencephalitic Syndrome / Q000150:complications*