The use of antivazoproliferative therapy in Vogt-Koyanagi-Harada syndrome (clinical case)

Rationale: Vogt-Koyanagi-Harada disease is a multisystem disease characterized by granulomatous panuveitis with exudative retinal detachment, choroidal thickening, often associated with neurological and cutaneous manifestations. One of the main complications that significantly reduces the patient’s visual acuity is the development of choroidal neovascular membranes. Objective: to describe the use of intravitreal bevacizumab for choroidal neovascular membrane associated with Vogt-Koyanagi-Harada syndrome. Methods: A clinical case of 25-year-old female patient with Vogt-Koyanagi-Harada disease complicated by the development of a subretinal neovascular membrane. Results. After the diagnosis of Vogt-Koyanagi-Harada syndrome, the patient with Vogt-Koyanagi-Harada syndrome was prescribed intravitreal injections of an anti-VEGF in addition to systemic anti-inflammatory therapy. After 2 intravitreal injections of bevacizumab, an increase in visual acuity, resorption of subretinal fluid and blood, cystic macular edema, and a decrease in the size of the subretinal neovascular membrane were observed. Conclusion. Chronicization of the Vogt-Koyanagi-Harada syndrome syndrome can lead to permanent visual loss associated with subretinal neovascular membrane. In such patients, a combined approach to treatment may be required. Intravitreal use of bevacizumab in combination with general anti-inflammatory treatment in our case led to regression of a subretinal neovascular membrane and visual acuity improvement.