Autofluorescence findings in Vogt-Koyanagi-Harada disease.
OBJECTIVE
To report shortwave autofluorescence (SW-AF) and near infrared autofluorescence (NIR-AF) findings in a case of Vogt-Koyanagi-Harada (VKH) disease.


METHODS
A 22-year-old man presented with a 2-week history of headache, moderate hearing loss, discolored hair, and bilateral gradually decreased vision (20/800 bilaterally). Ophthalmologic examinations revealed bilateral granulomatous anterior uveitis and multiple patchy bullous retinal detachments. Fundus fluorescein angiography (FFA), SW-AF, and NIR-AF imaging were performed with a confocal scanning laser ophthalmoscope at the beginning and after resolution. The patient responded well to systemic prednisolone treatment. Visual acuity and hearing loss improved quickly (visual acuity 16/20 bilaterally).


RESULTS
Multilobular dye pooling with a dark rim was observed in serous detached retinal areas on late-phase FFA. These areas were observed as hypoAF in SW-AF and NIR-AF mode due to the blockage. After resolution of serous detachment, numerous hypoAF granular dots were observed scattered over the previously serous detached areas in SW-AF and NIR-AF mode. These hypoAF granular dots were seen as window defect lesion in FFA and interpreted as retinal pigment epithelial damage or atrophy.


CONCLUSIONS
SW-AF and NIR-AF imaging confirmed granular retinal pigment epithelium atrophy which corresponds to FFA findings. SW-AF and NIR-AF imaging methods are noninvasive and useful techniques for documentation of fundus changes in VKH disease.
Ayata
Ali
A
Department of Ophthalmology, GATA Haydarpasa Training Hospital, Istanbul - Turkey. ali_ayata@yahoo.com
Dogru
Salim
S
Senol
Mehmet Guney
MG
Unal
Melih
M
Ersanli
Dilaver
D
Bilge
Ahmet Hamdi
AH
D001284:Atrophy; D005451:Fluorescein Angiography; D005938:Glucocorticoids / Q000627:therapeutic use; D034381:Hearing Loss / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D007834:Lasers; D008062:Lipofuscin / Q000378:metabolism; D008297:Male; D008543:Melanins / Q000378:metabolism; D009887:Ophthalmoscopy; D011239:Prednisolone / Q000627:therapeutic use; D012163:Retinal Detachment / Q000175:diagnosis / Q000188:drug therapy; D055213:Retinal Pigment Epithelium / Q000378:metabolism / Q000473:pathology*; D014606:Uveitis, Anterior / Q000175:diagnosis / Q000188:drug therapy; D014607:Uveomeningoencephalitic Syndrome / Q000175:diagnosis* / Q000188:drug therapy / Q000378:metabolism; D014786:Vision Disorders / Q000175:diagnosis / Q000188:drug therapy; D014792:Visual Acuity; D055815:Young Adult
D005938:Glucocorticoids; D008062:Lipofuscin; D008543:Melanins; D011239:Prednisolone