A Case of Vogt-Koyanagi-Harada Disease and Retinal Peri-Phlebitis in a Patient With Presumed Ocular Tuberculosis

A middle-aged hypertensive female presented with headaches, tinnitus, and blurred vision for two weeks. Clinical examination revealed mild vitritis and bilateral multifocal exudative detachments at the posterior pole, together with peripheral vascular cuffing and peri-phlebitis. Laboratory testing pointed towards isolated presumed intraocular tuberculosis (IOTB) as the probable cause. However, the patient strongly responded to high-dose intravenous and tapered oral corticosteroids, leading to complete resolution of detachments within 10 days of therapy initiation. Anti-tubercular therapy (ATT) was begun after one week of presentation, and no recurrence of symptoms was noted for the next 18 months. A case of VogtKoyanagi-Harada (VKH) disease-like presentation occurred after a probable previous subclinical episode(s) of presumed IOTB, resulting in sclerosed vessels in the retinal periphery.