A 55-year-old man (subject 1) presented with bilateral metamorphopsia, with decimal visual acuity being 0.8 in the right eye and 1.2 in the left. The clinical diagnosis of VKH was made based on bilateral panuveitis and multifocal exudative retinal detachments at the posterior poles (). High-dose corticosteroid therapy with gradual tapering was initiated 3 days after presentation. The serous detachments entirely resolved within 9 weeks and visual acuity in the right eye improved to 1.2.\nSerial spectral-domain OCT (SD-OCT) images obtained at the preuveitic, uveitic, and posttreatment phase are shown in . SD-OCT obtained 1 year before the onset of VKH due to symptoms of a floater and visual disturbance demonstrated a dome-shaped posterior protrusion of the RPE and outer retinal layers into the choroidal cavity (ie, conforming FCE) at the fovea in the right eye. SD-OCT at the uveitic phase identified multiple bilateral sensory retinal detachments, with the FCE now involving only the RPE (ie, nonconforming FCE). Nine weeks after the treatment, the nonconforming FCE returned into a conforming pattern.\nThe FCE pattern and its alteration during treatment of the case with VKH were compared to those of four subjects with FCE associated with other chorioretinal conditions (). This comparison group consisted of two patients with age-related macular degeneration (AMD; subjects 2 and 3), one subject with a macular hole (MH; subject 4), and one asymptomatic individual (subject 5). Treatment with intravitreal ranibizumab injections and vitrectomy had been performed in the patients with AMD and MH, respectively. A conforming FCE was observed in three patients (subjects 2, 3, and 5) and pattern alteration from nonconforming to conforming FCE was found after treatment in one subject (subject 4). In the two subjects with AMD, a hyperreflective material around the FCE was absorbed, resulting in a well-demarcated conforming FCE after treatment.
The chief complaint for this 29-year-old woman was impaired vision in her left eye. At the initial visit for this this patient, a photograph of her left fundus showed white dots (Figure B) with hyperautofluorescence on FAF (Figure D), while OCT revealed a disrupted or irregular photoreceptor inner outer segment (IS/OS) junction (Figure F) indicated by the arrows. At 1 month after her initial visit, this patient complained of metamorphopsia in her right eye. FP showed that there were white dots in the posterior pole (Figure A), while FAF images obtained using FAF revealed hyperfluorescence in the area surrounding the optic disc (Figure C). OCT showed a disrupted or irregular photoreceptor IS/OS junction in both eyes (Figure E and F) indicated by the arrows. At 4 months after her initial visit, there was almost complete improvement of the metamorphopsia in her right and left eyes. In addition, OCT indicated there was ongoing restoration of the IS/OS line in both eyes (Figure A and B). Although the deviation map of ganglion cell analysis showed there was a decrease of the GCL + IPL thickness in both eyes at her initial visit, her right eye was not affected. During the 4 months of follow-up, the deviation map (Figure C~J) did not indicate any recovery of the decreased GCL + IPL thickness. Signal strengths of all the Cirrus OCT measurements were 10/10.