A tale of two syndromes: Vogt–Koyanagi–Harada disease and acquired immunodeficiency syndrome in a Nigerian female

Abstract

A 54-year-old female Nigerian presented with a 1-week history of sudden deterioration of vision in both eyes. There was no antecedent history of ocular trauma, floaters, nor flashes of light. However, she gave a history of a febrile illness associated with headaches and malaise 2 weeks prior to onset of ocular symptoms. She is a known retroviral-positive patient on treatment with highly active antiretroviral therapy for the past 5 years but is not a known hypertensive nor diabetic. At presentation, the best corrected visual acuity was hand movement in both eyes. Anterior segment examination of both eyes revealed fine keratic precipitates on the corneal endothelium with flare and inflammatory cells in the anterior chamber and grade 1 nuclear sclerosis. Dilated binocular indirect ophthalmoscopy of both eyes revealed pink disks with blurred margins total exudative retinal detachments. An assessment of Vogt–Koyanagi–Harada syndrome in a patient with human immunodeficiency virus/acquired immunodeficiency syndrome was made. Bilateral exudative detachment resolved with improvement of her best corrected visual acuity to 6/9 in both eyes after systemic treatment with steroids.