VOGT-KOYANAGI-HARADA DISEASE WITH INITIAL PRESENTATION AS BILATERAL ACUTE ANGLE-CLOSURE ATTACK: A CASE REPORT

Purpose: To report a case of Vogt-Koyanagi-Harada disease with bilateral acute angle closure attack as initial presentation. Method: Case report and literature review. Results: A 39-year-old man presented with sudden onset of bilateral blurred vision and eye fullness. Ophthalmic examination revealed best corrected visual acuity of 6/10 in right eye and 6/6 in left eye. Goldmann applanation tonometry was 48 mmHg in right eye and 44 mmHg in left one. Anterior chambers were shallow with no cell or flare. Gonioscopy showed appositional angle closure in all quadrants bilaterally. Indirect ophthalmoscopy showed bilateral retina striae with serous detachment. Fluorescein angiography showed diffuse pinpoint dye leakage with localized subretinal fluid temporal to macula in both eyes. Left side tinnitus occurred about two weeks after onset of blurred vision. Vogt-Koyanagi-Harada disease was diagnosed concluding all clinical presentations. His visual acuity recovered to 6/6 bilaterally after steroid treatment and his intraocular pressure returned to normal range. Conclusion: Vogt-Koyanagi-Harada disease should be included in differential diagnosis of young patients with bilateral acute angle-closure attack despite little evidence of anterior segment inflammation.