MACULAR EDEMA IN CHRONIC VOGT-KOYANAGI-HARADA SYNDROME

Background: Macular edema is relatively rare in the Vogt-Koyanagi-Hara da (VKH) syndrome, in contrast to many other syndromes of chronic intr aocular inflammation, in which macular edema is relatively common. Fiv e eyes of three patients with chronic VKH syndrome and macular edema a re described. Methods: The authors retrospectively reviewed the clinic al and fluorescein angiographic records of 27 patients with chronic VK H syndrome (duration of disease more than 3 months) and identified thr ee patients (five eyes) who had macular edema. Fluorescein angiography was performed using a scanning laser ophthalmoscope. Results: These p atients had either unusually severe and protracted inflammation (3 eye s) or the presence of an epiretinal membrane (2 eyes). Fluorescein ang iography demonstrated prominent perifoveal fluorescein leakage with po oling of fluorescein within perifoveal cystoid spaces. Treatment with sub-Tenon's triamcinolone injections resulted in improvement of visual acuity by two or more Snellen lines in four of the five eyes. Conclus ion: Macular edema is an uncommon but treatable cause of late loss of vision in patients with the VKH syndrome, and may be the result of lea kage from perifoveal retinal capillaries or leakage of fluid at the le vel of the retinal pigment epithelium.