Vogt-Koyanagi-Harada disease during pregnancy.

Case report A 24-year-old Japanese woman was first examined in her 12th week of pregnancy for a complaint of blurred vision in both eyes accompanied by headache and hearing loss. Her visual acuity was 6/10 right eye and 6/12 left eye. She had 1+ cells and flare in both anterior chambers. Serous retinal detachment involved the macular areas of both eyes (Fig 1). Intraocular pressure was 20 mm Hg in each eye. General physical and neurological examinations revealed no abnormalities, and blood pressure was 110/72 mm Hg. The pregnancy progressed normally and she had no toxaemia of pregnancy. The results of blood cell counts, chemical examinations, and serum electrophoresis were normal. The serum levels of the female hormones were high as is typical in many normal pregnant women, and other hormones were within the normal ranges. The diagnosis ofVKH was confirmed on the basis of the typical ocular findings and above mentioned clinical signs. She was treated with neither systemic nor topical corticosteroids under close observation. Funduscopic findings at 5 days after disease onset remained unchanged in the right eye, but macular oedema of the left eye had developed and visual acuity worsened to 6/200. Her blood pressure was 108/70 mm Hg. Although serous retinal detachment could occur in severe hypertension, this patient's blood pressure was within the normal range throughout her course. Two weeks later, the visual acuity improved to 6/9 in each eye. Disseminated yellow-white nodules were seen in the subretinal regions (Dalen-Fuchs) (Fig 2). On the 26th day, the anterior chambers were clear and the serous retinal detachment had completely disappeared; the visual acuity was 6/6 right eye and 6/7 left eye. The uveitis has not recurred since the delivery of a normal baby.