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Case 3

Patient Presentation: A 46-year-old healthy Asian man was referred to ophthalmology for papilledema. He presented with a 2-day history of new onset headache accompanied by blurred vision in both his eyes. He had a CT brain, which was normal. On examination, his vision was 20/400 OD and 20/200 OS. There was no RAPD. Slit lamp examination demonstrated a mild AC reaction. Fundus examination and OCT macula are shown below:



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Question: Please describe the OCT macula photo above:

Question: What is the likely diagnosis?

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Question: What OCT findings aid in monitoring disease activity in this disease?

Question: What is the most effective treatment for this disease?

Learning Objectives:

1. VKH is a multi-system disease that manifests in the eye with bilateral granulomatous pan-uveitis. It is classically associated with multiple serous retinal detachments.

2. Measuring disease activity of VKH can be monitored on OCT by observing choroidal thickness and the height of the sub-retinal fluid.

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