Wall of Fame

Is your case great enough to be selected for our Wall of Fame? If so, we’ll post your name and case here for the world to see!

11/23: Anjana Mirajkar, Manish Nagpal and Navneet Mehrotra
Harada’s Disease

10/23: Will Gibson
Posterior scleritis with chorioretinal folds

9/23: Shivraj Tagare and Nishant Maindargi
Valsalva retinopathy drained with YAG laser

8/23: Mohammad Abbas
Laser-induced retinal break and vitreous hemorrhage

7/23: Joe Yuenpang Cheung
Group-type congenital pigmented nevi of the RPE (bear tracks)

6/23: Gil Calvão-Santos and Keissy Sousa
Waardenburg Syndrome

5/23: Natasa Draca and Ratko Lazic
Tattoo-induced Uveitis

4/23: Veronika Matello and Barbara Parolini
Case of the Year winner!
The EmPuzzled Eye

3/23: Emma Oreskovic and Natasha Draca
Optic Nerve Pit

2/23: Anjana Mirajkar
Giant RPE Tear

11/22: Veronika Matello and Barbara Parolini
Choroidal Hemangioma Widefield OCT

8/22: Nivesh Gupta
Ischemic Central Retinal Vein Occlusion

7/22: Omar Mulki:
Choroidal Osteoma

3/22: Erdem Dinç
Is Temporary ILM Flap Sufficient for MH Closure?

1/22: Veronika Matello and Barbara Parolini
Case of the Year winner!
Choroidal Transplant for Subfoveal AMD MNV

12/21: Otis Hertsenberg
Optic Nerve Coloboma with Pit

11/21: David Kilpatrick
Frosted Branch Angiitis from Sarcoidosis

10/21: Kumar Chugani
Coats Disease


Harada's Disease

Congratulations to Anjana Mirajkar, Manish Nagpal and Navneet Mehrotra for submitting the Retina Rocks Case of the Month. This 41YO female presented with headaches, redness, and pain OD for 1.5 months and OS for 2 weeks. She was diagnosed elsewhere with angle closure glaucoma, received a YAG peripheral iridotomy and started on glaucoma drops. She then saw multiple other doctors who diagnosed her with papilledema. Her CSF opening pressure was 21, and she was started on oral acetazolamide for a presumed diagnosis of idiopathic intracranial hypertension (IIH). In our office vision was 20/100 OD and 20/60 OS. Intraocular pressure (IOP) was 30mmHG. Anterior segments showed shallow anterior chambers with retrolental vitreous cells. Multicolor imaging shows bilateral irregular chorioretinal folds, multifocal serous detachments, and disc hyperemia (images 1 and 2, top). OCT scanning shows a bacillary layer detachment OD, subretinal fluid OS, and a bilateral undulating thickened choroid (images 1 and 2, bottom). Fluorescein angiography shows bilateral optic nerve and areas of pinpoint subretinal leakage (image 3). She was diagnosed with Harada’s disease and started on Intravenous methylprednisolone for 3 days followed by 60mg prednisone PO daily. She was also referred to rheumatology to start immunosuppressants. The acetazolamide was tapered and discontinued for the misdiagnosed IIH. One week later, vision improved to 20/40 OU, IOP was 10mmHG OU with marked bilateral improvement in the chorioretinal folds, macular fluid and choroidal thickening (images 4 and 5). A slow steroid taper began pending starting immunosuppressants. This case has many classic findings for Harada’s disease, including bilateral panuveitis, optic nerve swelling, thickened choroid, chorioretinal folds, and multifocal serous exudative retinal detachments. Patients with just ocular findings have Harada’s disease, whereas those with additional systemic findings (including vitiligo, poliosis, headache, vertigo, and hearing loss) have Vogt-Koyanagi-Harada (VKH) disease. This case also reminds us that it is easy to misdiagnose these complex uveitis cases, especially when all the ocular findings are not taken in total to try to give the patient a single, unifying disease.