Treatment of Persistent Serous Retinal Detachment in Vogt–koyanagi–harada Syndrome With Intravitreal Bevacizumab During the Systemic Steroid Treatment

In Brief Purpose: To report the use of bevacizumab in patients with Vogt–Koyanagi–Harada disease and persistent serous retinal detachment during the systemic steroid treatment. Methods: Four patients with bilateral Vogt–Koyanagi–Harada disease with the resolution of ocular inflammation presenting a serous retinal detachment involving the fovea that persisted for at least 1 month, despite systemic corticosteroid treatment, received an intravitreal injection of bevacizumab during the steroid tapering stage. Best-corrected visual acuity, central retinal thickness, and macular sensitivity were evaluated. Results: Of 8 eyes, 7 (87%) had complete resolution of subretinal fluid within 1 month following the treatment. After the treatment, the mean best-corrected visual acuity and macular sensitivity improved significantly (P < 0.001, analysis of variance). Compared with baseline, at all measurements, central retinal thickness decreased significantly (P < 0.01, Tukey–Kramer test). At 6 months, a significant correlation was found between best-corrected visual acuity and macular sensitivity in the central 8° (linear regression, r = −0.73; P = 0.03), whereas no correlation was found between central retinal thickness and both best-corrected visual acuity and macular sensitivity. Conclusion: Intravitreal injection of bevacizumab during the corticosteroid therapy may be a treatment option for patients with decreased visual function because of persistent serous retinal detachment associated with Vogt–Koyanagi–Harada syndrome. Intravitreal bevacizumab was injected into eight eyes of four patients with Vogt–Koyanagi–Harada disease and persistent serous retinal detachment during tapering of systemic steroid treatment. Patients responded with prompt resolution of serous retinal detachment and improvement in visual acuity and retinal sensitivity after a single injection of bevacizumab.