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Rossi S. 1, Testa F. 1, De Benedictis A. 1, Gallo B. 1, Colucci R. 1, Uccello R. 2, Piscosquito G. 2, Melone M. A. B. 2, Simonelli F. 1
1 Dipartimento Multidisciplinare di Specialità Medico‑Chirurgiche e Odontoiatriche Seconda Università degli Studi di Napoli Napoli, Italia;
2 Dipartimento di Scienze Medico-Chirurgiche di Internistica Clinica e Sperimentale “F. Magrassi-A. Lanzara” Seconda Università degli Studi di Napoli Napoli, Italia
Vogt-Koyanagi-Harada syndrome (VKH) is a chronic exudative bilateral uveitis, associated with symptoms and signs of meningo-encephalic and dermatologic involvement. In particular, the disease is characterized by headache, meningism, cranial nerve deficit, vertigo, alopecia and poliosis. Other ocular complications that can affect the patients are: glaucoma, cataract and neovascular membranes. The age of disease onset is between 30 and 50 years, with a slight predilection for females. A 44-year-old Caucasian woman presented to our department with a sudden decrease in visual acuity. A bilateral uveitis with exudative retinal detachment and papillitis was observed in absence of neurological symptoms. At first a massive intravenous dose of methylprednisolone was administered and subsequently replaced with an escalation dose of prednisone. After relapse, oral azathioprine administration was added to the corticosteroid therapy for maintenance therapy, normalizing the ophthalmological and neurological disorders in six months. In fact, the patient presented a visual acuity of 10/10 in both eyes, absence of edema or retinal detachment at Optical Coherence Tomography (OCT) and normal neurological exams and visual evoked potentials (PEV).