Objective/Purpose
To assess the role of multimodal imaging in the diagnosis of acute Vogt-Koyanagi-Harada (VKH) disease without clinically evident exudative retinal detachment (ERD).

Materials/Patients
Thirty six eyes of 18 consecutive patients (12 females and 6 males) aged between 23 and 60 years (Mean 39 years).

Methods
All patients underwent clinical examination, color fundus photography, optical coherence tomography (OCT), fluorescein angiography (FA), indocyanine green angiography (ICGA), and B ultrasonography.

Results and Conclusion
Of 36 eyes, 22 (61%) had panuveitis and 14 (39%) had posterior uveitis. Main fundus findings included optic disc swelling in 30 eyes (83%) and choroidal / retinal folds in 20 eyes (55%). OCT findings included multifocal folds of retinal pigment epithelium in 23 eyes (64%), a shallow, limited ERD in 18 eyes (50%). FA findings included delayed choroidal perfusion in at least one eye of all patients (100%), hyperfluorescent pinpoints without obvious subretinal pooling in 21 eyes (58%), and optic disc hyperfluorescence in 35 eyes (97%). ICGA findings included delayed choroidal perfusion in 24 eyes (67%), decrease in the number of large choroidal vessels in 36 eyes (100%), fuzzy choroidal vessels in 35 eyes (97%), and hypofluorescent dark dots during the intermediate phase either becoming isofluorescent or remaining hypofluorescent in the late phase in 28 eyes (78%). B ultrasonography showed diffuse, low to medium reflective choroidal thickening in all eyes (100%).
A careful clinical examination combined with multimodal imaging approach, including OCT, FA, ICGA, and ultrasonography is mandatory for the early, definite diagnosis of acute VKH disease without clinically evident ERD.

[ Keyword ]
Vogt Koyanagi Harada disease / Exudative retinal detachment / Multimodal imaging

[ Conflict of Interest ]
No