Intravitreal triamcinolone acetonide in Vogt-Koyanagi-Harada syndrome M. KARACORLU, S. ARF KARACORLU, H. OZDEMIR Istanbul Retina Institute, Inc., Istanbul - Turkey INTRODUCTION Vogt-Koyanagi-Harada syndrome is a systemic disorder involving multiple organ systems, including the ocular, au- ditory, nervous, and integumentary systems. Severe bilat- eral panuveitis associated with exudative retinal detach- ment is the hallmark of ocular disease. High-dose systemic corticosteroid therapy has become the mainstay treatment for Vogt-Koyanagi-Harada syndrome and sec- ondary side effects are frequent (1). The purpose of the present study was to report the use of intravitreal triamci- nolone acetonide in two eyes of a patient with Vogt-Koy- anagi-Harada syndrome. Case report A 24-year-old otherwise healthy woman was presented with blurred vision in both eyes for 3 days associated with headache and dysacusia. Visual acuity was 20/50 in the right eye and 20/100 in the left. Anterior segment exami- nation was normal in both eyes. Funduscopy of both eyes demonstrated papillitis and serous retinal detachments as well as intraretinal edema. Intraocular pressure was 14 mm Hg in both eyes. Fluorescein angiography showed multiple hyperfluorescent leaking foci of retinal pigment epithelium in the early phase with rapid dye staining, re- sulting in enlargement and coalescence of lesions (Fig. 1, A and B). Optical coherence tomography showed large multiple serous retinal detachments involving the macular area (Fig. 1, C and D). She was treated with a single 4-mg dose of intravitreal injection of triamcinolone acetonide (Kenacort-A; 40 mg /mL, Bristol-Myers Squibb Co, Princeton, NJ) in both eyes. The left eye was treated 2 days prior to the right eye. The patient was fully informed about the experimental character of the treatment and had signed an informed consent. After 1 week the serous European Journal of Ophthalmology / Vol. 16 no. 3, 2006 / pp. 481-483 1120-6721/481-03$15.00/0 © Wichtig Editore, 2006 PURPOSE. To report the results of intravitreal triamcinolone acetonide in two eyes of a pa- tient with Vogt-Koyanagi-Harada syndrome. METHODS. A 24-year-old woman with Vogt-Koyanagi-Harada syndrome was treated with a single 4-mg dose of intravitreal injection of triamcinolone acetonide in both eyes. RESULTS. On the seventh day after injection, visual acuity improved from 20/50 to 20/20 in the right eye and from 20/100 to 20/32 in the left. One month after injection, visual acuity was 20/20 in the right eye and 20/32 in the left, and fluorescein angiography showed that serous detachment had almost completely resorbed. The ocular examination remained sta- ble during the 8-month follow-up period. CONCLUSIONS. In this study, a prompt improvement in the clinical picture of a patient with Vogt- Koyanagi-Harada syndrome after intravitreal triamcinolone acetonide injection was described. The results suggest that intravitreal triamcinolone acetonide injection may be an additional tool in the treatment of Vogt-Koyanagi-Harada syndrome. (Eur J Ophthalmol 2006; 16: 481-3) KEY WORDS. Vogt-Koyanagi-Harada syndrome, Intravitreal triamcinolone acetonide Accepted: November 28, 2005 SHORT COMMUNICATION