하라다병 환자에서 섬모체맥락막 삼출로 인해 발생한 양안의 급성 근시와 전방각 폐쇄 1예 = Bilateral Acute Myopia and Angle-Closure Due to Ciliochoroidal Effusion in Vogt-Koyanagi-Harada Syndrome

다국어 초록 (Multilingual Abstract)

Purpose: To report a case of bilateral acute myopia and angle-closure with ciliochoroidal detachment in Vogt-Koyanagi-Harada (VKH) syndrome. Case summary: A 43-year-old Korean woman diagnosed with VKH syndrome underwent intravenous methylprednisolone steroid pulse treatment. After oral medication was given for 2 days, the anterior chambers became shallow in both eyes. Intraocular pressure (IOP) increased to 25 mm Hg in the right eye and 23 mm Hg in the left eye. Subretinal fluid increased and visual acuity decreased with myopic shift in both eyes. IOP did not decrease despite maximum tolerated medical therapy. Ultrasound biomicroscopy (UBM) revealed that ciliochoroidal effusion caused forward displacement of the lens-iris diaphragm, which resulted in anterior chamber shallowing and angle closure in both eyes. The patient was treated with cycloplegic eyedrops and intravenous steroid pulse therapy. After intravenous steroid pulse treatment was given for 2 days, the anterior chambers became deep in both eyes. IOP reduced to 13 mm Hg and 14 mm Hg in the right and left eye respectively. Visual acuity increased with normalization of myopic shift. UBM revealed that the ciliochoroidal effusion had resolved in both eyes. J Korean Ophthalmol Soc 2012;53(8):1194-1199

참고문헌 (Reference)

1 Moorthy RS, "Vogt-Koyanagi-Harada syndrome" 39 : 265-292, 1995

2 Sugiura S, "Vogt-Koyanagi-Harada disease" 22 : 9-35, 1978

3 Gohdo T, "Ultrasound biomicroscopy of shallow anterior chamber in Vogt-Koyanagi-Harada syndrome" 122 : 112-114, 1996

4 Nakamura H, "Ultrasound biomicroscopy in the management of Vogt-Koyanagi-Harada disease" 78 : 718-719, 2000

5 Wada S, "Ultrasound biomicroscopic study of ciliary body changes in the post-treatment phase of Vogt-Koyanagi-Harada disease" 86 : 1374-1379, 2002

6 Kishi A, "Ultrasound biomicroscopic findings of acute angle-closure glaucoma in Vogt-Koyanagi-Harada syndrome" 122 : 735-737, 1996

7 Kawano Y, "Ultrasound biomicroscopic analysis of transient shallow anterior chamber in Vogt- Koyanagi-Harada syndrome" 121 : 720-723, 1996

8 Kimura R, "Transient shallow anterior chamber as initial symptom in Harada’s syndrome" 99 : 1604-1606, 1981

9 Kimura R, "Swollen ciliary processes as an initial symptom in Vogt-Koyanagi-Harada syndrome" 95 : 402-403, 1983

10 Maruyama Y, "Serous detachment of the ciliary body in Harada disease" 125 : 666-672, 1998

11 Ikeda N, "Pathogenesis of transient high myopia after blunt eye trauma" 109 : 501-507, 2002

12 안재균, "Morphologic changes in the anterior segment in patients with initial-onset or recurrent vogt-koyanagi-harada disease" TAYLOR & FRANCIS INC 18 (18): 314-318, 201008

13 Forster DJ, "Incidence and management of glaucoma in Vogt-Koyanagi-Harada syndrome" 100 : 613-618, 1993

14 Tokuoka S, "Harada’s disease with shallow anterior chamber, myopia and intraocular pressure rise in a pair of siblings" 42 : 365-368, 1988

15 Ashizuka S, "Ciliochoroidal detachment in Vogt-Koyanagi-Harada syndrome" 51 : 1067-1070, 1997

16 Eibschitz-Tsimhoni M, "Bilateral angle closure glaucoma: an unusual presentation of Vogt-Koyanagi- Harada syndrome" 81 : 705-706, 1997

17 Rathinam SR, "Angle closure glaucoma as a presenting sign of Vogt-Koyanagi-Harada syndrome" 81 : 608-609, 1997