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Photo Essay |

Pseudotumoral Retinal Pigment Epithelium Proliferation in a Patient With Vogt-Koyanagi-Harada Disease

Moncef Khairallah, MD; Narsing A. Rao, MD; Salim Ben Yahia, MD; Sonia Zaouali, MD; Sonia Attia, MD
Arch Ophthalmol. 2006;124(9):1366-1367. doi:10.1001/archopht.124.9.1366.
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A 22-year-old woman with a 4-year history of panuveitis associated with serous retinal detachment was referred to us for a juxtapapillary subretinal pigmented mass in both eyes. Her visual acuity was 20/100 OU. Slitlamp examination showed residual posterior synechiae bilaterally. There were no cells in the anterior chamber or vitreous. Intraocular pressure was normal. Fundus examination showed features of chronic recurrent Vogt-Koyanagi-Harada disease, including “sunset glow fundus,” hyperpigmented striae, and multiple atrophic chorioretinal spots in the periphery.1,2 A bilateral, darkly pigmented, exuberant subretinal mass extended to the juxtapapillary area, encroaching the optic nerve, with associated subretinal fibrosis and overlying serous retinal detachment (Figure 1). The pigmented mass was hypofluorescent on both fluorescein and indocyanine green angiography, with staining of subretinal fibrosis and the optic discs on fluorescein angiography. B-mode ultrasonography showed bilaterally a well-delineated echogenic mass with encroachment to the optic disc and without choroidal infiltration (Figure 2).

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Figure 1.

Fundus photographs (A and B, right and left eye, respectively) show “sunset glow fundus” bilaterally and hyperpigmented striae (A) as seen in Vogt-Koyanagi-Harada disease. A darkly pigmented, exuberant subretinal mass extends in the juxtapapillary area, encroaching the optic nerve. Note the presence of subretinal fibrosis and an overlying serous retinal detachment.

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Figure 2.

B-mode ultrasonography (A and B, right and left eye, respectively) shows bilaterally a well-delineated echogenic mass encroaching the optic disc with no evidence of choroidal infiltration.

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