title: Two cases of Vogt-Koyanagi-Harada's disease in sub-Saharan Africa.
abstract: Vogt-Koyanagi-Harada's (VKH) disease has been reported to be rare in sub-Saharan Africa. Two Nigerians with the disease are presented in this report. The first patient, a 32-year-old pregnant Nigerian woman presented with a 1-month history of bilateral blurring of vision, persistent headache, and alopecia. Presenting visual acuity was 1 m counting fingers in both eyes. Examination revealed vitiligo and poliosis with bilateral panuveitis as well as bilateral exudative retinal detachment. A clinical assessment of complete VKH disease was made. The patient commenced systemic and topical steroids that resulted in remarkable recovery of vision and control of inflammation. The second patient, a 56-year-old Nigerian woman presented with severe headache, tinnitus, and visual loss in both eyes of 2 weeks duration. There was associated redness of both eyes and photophobia. Examination showed visual acuity of Hand motion (HM) and counting fingers at 1 meter (CF). in the right and left eye, respectively, with bilateral panuveitis and bilateral exudative retinal detachment. Subsequent follow-up showed poliosis, vitiligo, and sunsetting fundus appearance. The patient improved with systemic and topical corticosteroids. Developing a high index of suspicion is necessary in diagnosing VKH disease, even in sub-Saharan Africa. Prompt institution of appropriate treatment prevents blindness.
authors.affiliation: Retina and Vitreous Unit, Department of Ophthalmology, University College Hospital, Ibadan.
authors.forename: Tunji S
authors.initials: TS
authors.lastname: Oluleye
authors.affiliation: Department of Ophthalmology, Guinness Eye Center, Lagos University Teaching Hospital, Lagos, Nigeria.
authors.forename: Adekunle O
authors.initials: AO
authors.lastname: Rotimi-Samuel
authors.affiliation: Department of Ophthalmology, Guinness Eye Center, Lagos University Teaching Hospital, Lagos, Nigeria.
authors.forename: Adetunji
authors.initials: A
authors.lastname: Adenekan
authors.affiliation: Department of Ophthalmology, Guinness Eye Center, Lagos University Teaching Hospital, Lagos, Nigeria.
authors.forename: Olubanke T
authors.initials: OT
authors.lastname: Ilo
authors.affiliation: Department of Ophthalmology, Guinness Eye Center, Lagos University Teaching Hospital, Lagos, Nigeria.
authors.forename: Folashade B
authors.initials: FB
authors.lastname: Akinsola
authors.affiliation: Department of Ophthalmology, Guinness Eye Center, Lagos University Teaching Hospital, Lagos, Nigeria.
authors.forename: Adeola O
authors.initials: AO
authors.lastname: Onakoya
authors.affiliation: Department of Ophthalmology, Guinness Eye Center, Lagos University Teaching Hospital, Lagos, Nigeria.
authors.forename: Olufisayo T
authors.initials: OT
authors.lastname: Aribaba
authors.affiliation: Department of Ophthalmology, Guinness Eye Center, Lagos University Teaching Hospital, Lagos, Nigeria.
authors.forename: Adebukunola
authors.initials: A
authors.lastname: Adefule-Ositelu
authors.affiliation: Department of Ophthalmology, Guinness Eye Center, Lagos University Teaching Hospital, Lagos, Nigeria.
authors.forename: Kareem O
authors.initials: KO
authors.lastname: Musa
authors.affiliation: Department of Ophthalmology, Guinness Eye Center, Lagos University Teaching Hospital, Lagos, Nigeria.
authors.forename: Yele
authors.initials: Y
authors.lastname: Oyefeso
keywords: Vogt–Koyanagi–Harada’s disease; exudative retinal detachment; sub-Saharan Africa; vitiligo