J Korean Ophthalmol Soc > Volume 48(11); 2007 > Article
Journal of the Korean Ophthalmological Society 2007;48(11):1588-1592.
DOI: https://doi.org/10.3341/jkos.2007.48.11.1588    Published online November 30, 2007.
Vogt-Koyanagi-Harada Disease Associated with Bilateral Tonic Pupils in a Pregnant Patient.
Jae Sung Park, Jun Mo Park, Ji Eun Lee, Boo Sup Oum
Department of Ophthalmology, College of Medicine, Pusan National University, Pusan, Korea. bsoum@pusan.ac.kr
임신 중 발생한 보크트-고야나기-하라다 병에 합병된 긴장성 동공 1예
박재성,박준모,이지은,엄부섭
Department of Ophthalmology, College of Medicine, Pusan National University, Pusan, Korea
Correspondence:  Boo Sup Oum, M.D.
Abstract
PURPOSE
We report a case of bilateral tonic pupils and decreased corneal sensitivity in a patient with Vogt-Koyanagi-Harada (VKH) disease during pregnancy. CASE SUMMARY: A 33-year-old Korean woman in the sixth month of pregnancy presented with visual impairment in both eyes. Her best corrected visual acuity was 0.2 in the right eye and 0.125 in the left. Slit-lamp examination revealed cells in the anterior chamber and serous retinal detachments in both eyes. The patient was treated with topical corticosteroid in both eyes and posterior subtenon injection of triamcinolone acetonide in the left eye. The serous retinal detachment resolved completely at 2 months in the left eye and at 3 months in the right. As pigmentation of the retina developed, VKH disease was confirmed. The patient complained of photophobia, and both pupils were found to be enlarged to 8 mm without dilation. Light reflex was absent and near reflex was suppressed and slow. After instillation of 0.125% pilocarpine, the pupils were constricted to 3.5 mm and were diagnosed as tonic pupils. Though the patient's corrected visual acuity improved to 0.8 in the right eye and 1.0 in the left at 6 months, her pupils remained unchanged. Corneal sensitivity was decreased. CONCLUSIONS: Tonic pupils may be complicated with VKH disease even during pregnancy. We recommend examinations of the pupils and corneal sensitivity in patients with VKH disease, especially those complaining of photophobia.
Key Words: Corneal sensitivity;Pregnancy;Tonic pupil;Vogt-Koyanagi-Harada disease


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