Anterior ischemic optic neuropathy (AION) is infrequently complicated with Vogt-Koyanagi-Harada (VKH) disease. We quantitatively examined sequential changes in the morphology and circulation hemodynamics, using a C-scan of optical coherence tomography (OCT) and laser speckle flowgraphy (LSFG) in a patient with VKH disease accompanied by AION. A 65-year-old female complained of blurred vision in both of her eyes. The patient presented with optic disc swelling and remarkable choroidal thickening detected by OCT bilaterally. The diagnosis of VKH disease was established based on the presence of pleocytosis detected in the cerebrospinal fluid and hypofluorescent dark dots scattered all around the fundus, detected by indocyanine green angiography. Goldmann perimetry detected visual field defects, similar to superior altitudinal hemianopsia in the right eye and similar to inferior altitudinal hemianopsia in the left eye. The patient was suspected to have developed AION in both eyes. The patient received methylprednisolone pulse therapy, followed by oral prednisolone. With these treatments, the optic disc swelling disappeared. However, optic disc atrophy with visual field defects remained in both eyes. An OCT C-scan showed the ganglion cell complex (GCC) and circumpapillary retinal nerve fiber layer (cpRNFL) thickness getting thinner below the normal range, and LSFG showed the decrease in optic nerve head (ONH) tissue microcirculation. These results supported the occurrence of AION in this patient with VKH disease. The analysis of GCC and cpRNFL thickness and ONH microcirculation would be useful for supporting the occurrence of AION in a case of VKH disease.
Case Rep Ophthalmol 2021;12:899–908

中文翻译：

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Vogt-Koyanagi-Harada病合并前部缺血性视神经病变眼的视神经头微循环

前部缺血性视神经病变 (AION) 很少并发 Vogt-Koyanagi-Harada (VKH) 病。我们使用光学相干断层扫描 (OCT) 和激光散斑流成像 (LSFG) 的 C 扫描对伴有 AION 的 VKH 病患者进行形态学和循环血流动力学的连续变化进行定量检查。一名 65 岁女性主诉双眼视力模糊。患者表现为双侧 OCT 检测到的视盘肿胀和显着的脉络膜增厚。VKH 病的诊断是基于脑脊液中检测到的细胞增多症和散在眼底周围的低荧光暗点的存在，通过吲哚菁绿血管造影检测到。戈德曼视野检测检测视野缺损，类似于右眼的上高度偏盲和左眼的下高度偏盲。怀疑患者双眼均出现 AION。患者接受甲泼尼龙冲击治疗，随后口服泼尼松龙。通过这些治疗，视盘肿胀消失了。然而，双眼仍存在视盘萎缩和视野缺损。OCT C 扫描显示神经节细胞复合体 (GCC) 和视乳头周围视网膜神经纤维层 (cpRNFL) 厚度在正常范围以下变薄，LSFG 显示视神经乳头 (ONH) 组织微循环减少。这些结果支持该 VKH 病患者发生 AION。
Case Rep Ophthalmol 2021；12:899–908