title: Vogt-Koyanagi-Harada disease following BCG vaccination and tuberculosis.
abstract: BACKGROUND
  To describe the characteristics, diagnosis, and treatment of the first documented case of Vogt-Koyanagi-Harada (VKH) disease following BCG vaccination (Patient 1) and the first documented case of both VKH disease and tuberculosis (Patient 2). Two patients were diagnosed with VKH disease and monitored using fundus photography, fundus autofluorescence, fluorescein angiography (FA), spectral-domain optical coherence tomography, and enhanced depth imaging optical coherence tomography (EDI-OCT).
  
  
  METHODS
  A 39-year-old patient (Patient 1) had bilateral granulomatous anterior uveitis and serous retinal detachment. FA showed multiple punctuate hyperfluorescent lesions and multilobular pools of dye. EDI-OCT revealed serous retinal detachment, subretinal septa, and cystoid spaces. A 40-year-old woman (Patient 2) presented with a 3-week history of decreased vision, headache and tinnitus. Fundus examination showed bilateral disc swelling with serous retinal detachment and retinal folds. She had been diagnosed with tuberculosis. EDI-OCT showed fluctuation of the internal limiting membrane (ILM), retinal folds, retinal pigment epithelial (RPE)-Bruch membrane undulation, choroidal folds, serous retinal detachment. Both of the patients received high dosage of steroid treatment during the diagnosis. A fast recovery in VKH symptoms was observed following the treatment.
  
  
  RESULTS
  Immunological mechanisms and dysregulation of the immune system may play a significant role in the association between VKH disease and BCG.
  
  
  CONCLUSIONS
  EDI-OCT imaging demonstrated structural changes in the photoreceptor layer, RPE-Bruch membrane, choroid, outer retina, ILM in acute VKH.
authors.affiliation: Department of Ophthalmology, Antalya Training and Research Hospital, Varlık Mh., Kazim Karabekir Caddesi, 07100 Antalya, Turkey.
authors.forename: Berna
authors.initials: B
authors.lastname: Dogan
authors.affiliation: Department of Ophthalmology, Antalya Training and Research Hospital, Varlık Mh., Kazim Karabekir Caddesi, 07100 Antalya, Turkey.
authors.forename: Muhammet Kazim
authors.initials: MK
authors.lastname: Erol
authors.affiliation: Department of Ophthalmology, Antalya Training and Research Hospital, Varlık Mh., Kazim Karabekir Caddesi, 07100 Antalya, Turkey.
authors.forename: Ayse
authors.initials: A
authors.lastname: Cengiz
keywords: BCG vaccine; Serous retinal detachment; Tuberculosis; Vogt–Koyanagi–Harada disease