NANOSNET

Hi Dear All，

I have a patient for whom I would appreciate your opinions. 

A previously healthy 32-year-old female with acute VKH is on oral prednisone 50 mg daily for two weeks. FFA and OCT findings are typical for VKH, with a few cells in the anterior chamber. Repeat OCT shows significant improvement, with only subfoveal fluid. However, the patient reports worsening vision, and progress within a few days, her visual acuity drops from 20/50 to HM in both eyes, without having received any other immunosuppressive agents. Orbital and brain MRI w/o contrast are unremarkable. CBC and basic metabolic panel show no abnormalities. Serum AQP4 and MOG antibodies are negative. Syphilis, HIV, ACE, and ANA are also negative. Chest x-ray is normal. The uveitis specialist added mycophenolate later. 

When I saw the patient, visual acuity was HM in both eyes, both pupils were 4 mm with no reaction to light, the anterior chamber was quiet, and the fundus appeared normal. A full-field ERG showed nearly undetectable waveforms. I ordered anti-retinal antibodies but the results are still pending. I am considering IVMP 1 g, but I'm not sure whether steroid pulse therapy will be effective in her case. Should PLEX or IVIG be prioritized instead? Is a PET-CT also indicated? 

Any input is welcome.

Thanks!

Hi Dear All，

I have a patient for whom I would appreciate your opinions. 

A previously healthy 32-year-old female with acute VKH is on oral prednisone 50 mg daily for two weeks. FFA and OCT findings are typical for VKH, with a few cells in the anterior chamber. Repeat OCT shows significant improvement, with only subfoveal fluid. However, the patient reports worsening vision, and progress within a few days, her visual acuity drops from 20/50 to HM in both eyes, without having received any other immunosuppressive agents. Orbital and brain MRI w/o contrast are unremarkable. CBC and basic metabolic panel show no abnormalities. Serum AQP4 and MOG antibodies are negative. Syphilis, HIV, ACE, and ANA are also negative. Chest x-ray is normal. The uveitis specialist added mycophenolate later. 

When I saw the patient, visual acuity was HM in both eyes, both pupils were 4 mm with no reaction to light, the anterior chamber was quiet, and the fundus appeared normal. A full-field ERG showed nearly undetectable waveforms. I ordered anti-retinal antibodies but the results are still pending. I am considering IVMP 1 g, but I'm not sure whether steroid pulse therapy will be effective in her case. Should PLEX or IVIG be prioritized instead? Is a PET-CT also indicated? 

Any input is welcome.

Thanks!

Hi Dear All，

I have a patient for whom I would appreciate your opinions. 

A previously healthy 32-year-old female with acute VKH is on oral prednisone 50 mg daily for two weeks. FFA and OCT findings are typical for VKH, with a few cells in the anterior chamber. Repeat OCT shows significant improvement, with only subfoveal fluid. However, the patient reports worsening vision, and progress within a few days, her visual acuity drops from 20/50 to HM in both eyes, without having received any other immunosuppressive agents. Orbital and brain MRI w/o contrast are unremarkable. CBC and basic metabolic panel show no abnormalities. Serum AQP4 and MOG antibodies are negative. Syphilis, HIV, ACE, and ANA are also negative. Chest x-ray is normal. The uveitis specialist added mycophenolate later. 

When I saw the patient, visual acuity was HM in both eyes, both pupils were 4 mm with no reaction to light, the anterior chamber was quiet, and the fundus appeared normal. A full-field ERG showed nearly undetectable waveforms. I ordered anti-retinal antibodies but the results are still pending. I am considering IVMP 1 g, but I'm not sure whether steroid pulse therapy will be effective in her case. Should PLEX or IVIG be prioritized instead? Is a PET-CT also indicated? 

Any input is welcome.

Thanks!

Hi Dear All，

I have a patient for whom I would appreciate your opinions. 

A previously healthy 32-year-old female with acute VKH is on oral prednisone 50 mg daily for two weeks. FFA and OCT findings are typical for VKH, with a few cells in the anterior chamber. Repeat OCT shows significant improvement, with only subfoveal fluid. However, the patient reports worsening vision, and progress within a few days, her visual acuity drops from 20/50 to HM in both eyes, without having received any other immunosuppressive agents. Orbital and brain MRI w/o contrast are unremarkable. CBC and basic metabolic panel show no abnormalities. Serum AQP4 and MOG antibodies are negative. Syphilis, HIV, ACE, and ANA are also negative. Chest x-ray is normal. The uveitis specialist added mycophenolate later. 

When I saw the patient, visual acuity was HM in both eyes, both pupils were 4 mm with no reaction to light, the anterior chamber was quiet, and the fundus appeared normal. A full-field ERG showed nearly undetectable waveforms. I ordered anti-retinal antibodies but the results are still pending. I am considering IVMP 1 g, but I'm not sure whether steroid pulse therapy will be effective in her case. Should PLEX or IVIG be prioritized instead? Is a PET-CT also indicated? 

Any input is welcome.

Thanks!

Hi Dear All，

I have a patient for whom I would appreciate your opinions. 

A previously healthy 32-year-old female with acute VKH is on oral prednisone 50 mg daily for two weeks. FFA and OCT findings are typical for VKH, with a few cells in the anterior chamber. Repeat OCT shows significant improvement, with only subfoveal fluid. However, the patient reports worsening vision, and progress within a few days, her visual acuity drops from 20/50 to HM in both eyes, without having received any other immunosuppressive agents. Orbital and brain MRI w/o contrast are unremarkable. CBC and basic metabolic panel show no abnormalities. Serum AQP4 and MOG antibodies are negative. Syphilis, HIV, ACE, and ANA are also negative. Chest x-ray is normal. The uveitis specialist added mycophenolate later. 

When I saw the patient, visual acuity was HM in both eyes, both pupils were 4 mm with no reaction to light, the anterior chamber was quiet, and the fundus appeared normal. A full-field ERG showed nearly undetectable waveforms. I ordered anti-retinal antibodies but the results are still pending. I am considering IVMP 1 g, but I'm not sure whether steroid pulse therapy will be effective in her case. Should PLEX or IVIG be prioritized instead? Is a PET-CT also indicated? 

Any input is welcome.

Thanks!

Hi Dear All，

I have a patient for whom I would appreciate your opinions. 

A previously healthy 32-year-old female with acute VKH is on oral prednisone 50 mg daily for two weeks. FFA and OCT findings are typical for VKH, with a few cells in the anterior chamber. Repeat OCT shows significant improvement, with only subfoveal fluid. However, the patient reports worsening vision, and progress within a few days, her visual acuity drops from 20/50 to HM in both eyes, without having received any other immunosuppressive agents. Orbital and brain MRI w/o contrast are unremarkable. CBC and basic metabolic panel show no abnormalities. Serum AQP4 and MOG antibodies are negative. Syphilis, HIV, ACE, and ANA are also negative. Chest x-ray is normal. The uveitis specialist added mycophenolate later. 

When I saw the patient, visual acuity was HM in both eyes, both pupils were 4 mm with no reaction to light, the anterior chamber was quiet, and the fundus appeared normal. A full-field ERG showed nearly undetectable waveforms. I ordered anti-retinal antibodies but the results are still pending. I am considering IVMP 1 g, but I'm not sure whether steroid pulse therapy will be effective in her case. Should PLEX or IVIG be prioritized instead? Is a PET-CT also indicated? 

Any input is welcome.

Thanks!

Hi Dear All，

I have a patient for whom I would appreciate your opinions. 

A previously healthy 32-year-old female with acute VKH is on oral prednisone 50 mg daily for two weeks. FFA and OCT findings are typical for VKH, with a few cells in the anterior chamber. Repeat OCT shows significant improvement, with only subfoveal fluid. However, the patient reports worsening vision, and progress within a few days, her visual acuity drops from 20/50 to HM in both eyes, without having received any other immunosuppressive agents. Orbital and brain MRI w/o contrast are unremarkable. CBC and basic metabolic panel show no abnormalities. Serum AQP4 and MOG antibodies are negative. Syphilis, HIV, ACE, and ANA are also negative. Chest x-ray is normal. The uveitis specialist added mycophenolate later. 

When I saw the patient, visual acuity was HM in both eyes, both pupils were 4 mm with no reaction to light, the anterior chamber was quiet, and the fundus appeared normal. A full-field ERG showed nearly undetectable waveforms. I ordered anti-retinal antibodies but the results are still pending. I am considering IVMP 1 g, but I'm not sure whether steroid pulse therapy will be effective in her case. Should PLEX or IVIG be prioritized instead? Is a PET-CT also indicated? 

Any input is welcome.

Thanks!

Hi Dear All，

I have a patient for whom I would appreciate your opinions. 

A previously healthy 32-year-old female with acute VKH is on oral prednisone 50 mg daily for two weeks. FFA and OCT findings are typical for VKH, with a few cells in the anterior chamber. Repeat OCT shows significant improvement, with only subfoveal fluid. However, the patient reports worsening vision, and progress within a few days, her visual acuity drops from 20/50 to HM in both eyes, without having received any other immunosuppressive agents. Orbital and brain MRI w/o contrast are unremarkable. CBC and basic metabolic panel show no abnormalities. Serum AQP4 and MOG antibodies are negative. Syphilis, HIV, ACE, and ANA are also negative. Chest x-ray is normal. The uveitis specialist added mycophenolate later. 

When I saw the patient, visual acuity was HM in both eyes, both pupils were 4 mm with no reaction to light, the anterior chamber was quiet, and the fundus appeared normal. A full-field ERG showed nearly undetectable waveforms. I ordered anti-retinal antibodies but the results are still pending. I am considering IVMP 1 g, but I'm not sure whether steroid pulse therapy will be effective in her case. Should PLEX or IVIG be prioritized instead? Is a PET-CT also indicated? 

Any input is welcome.

Thanks!

Hi Dear All，

I have a patient for whom I would appreciate your opinions. 

A previously healthy 32-year-old female with acute VKH is on oral prednisone 50 mg daily for two weeks. FFA and OCT findings are typical for VKH, with a few cells in the anterior chamber. Repeat OCT shows significant improvement, with only subfoveal fluid. However, the patient reports worsening vision, and progress within a few days, her visual acuity drops from 20/50 to HM in both eyes, without having received any other immunosuppressive agents. Orbital and brain MRI w/o contrast are unremarkable. CBC and basic metabolic panel show no abnormalities. Serum AQP4 and MOG antibodies are negative. Syphilis, HIV, ACE, and ANA are also negative. Chest x-ray is normal. The uveitis specialist added mycophenolate later. 

When I saw the patient, visual acuity was HM in both eyes, both pupils were 4 mm with no reaction to light, the anterior chamber was quiet, and the fundus appeared normal. A full-field ERG showed nearly undetectable waveforms. I ordered anti-retinal antibodies but the results are still pending. I am considering IVMP 1 g, but I'm not sure whether steroid pulse therapy will be effective in her case. Should PLEX or IVIG be prioritized instead? Is a PET-CT also indicated? 

Any input is welcome.

Thanks!

Hi Dear All，

I have a patient for whom I would appreciate your opinions. 

A previously healthy 32-year-old female with acute VKH is on oral prednisone 50 mg daily for two weeks. FFA and OCT findings are typical for VKH, with a few cells in the anterior chamber. Repeat OCT shows significant improvement, with only subfoveal fluid. However, the patient reports worsening vision, and progress within a few days, her visual acuity drops from 20/50 to HM in both eyes, without having received any other immunosuppressive agents. Orbital and brain MRI w/o contrast are unremarkable. CBC and basic metabolic panel show no abnormalities. Serum AQP4 and MOG antibodies are negative. Syphilis, HIV, ACE, and ANA are also negative. Chest x-ray is normal. The uveitis specialist added mycophenolate later. 

When I saw the patient, visual acuity was HM in both eyes, both pupils were 4 mm with no reaction to light, the anterior chamber was quiet, and the fundus appeared normal. A full-field ERG showed nearly undetectable waveforms. I ordered anti-retinal antibodies but the results are still pending. I am considering IVMP 1 g, but I'm not sure whether steroid pulse therapy will be effective in her case. Should PLEX or IVIG be prioritized instead? Is a PET-CT also indicated? 

Any input is welcome.

Thanks!

Hi Dear All，

I have a patient for whom I would appreciate your opinions. 

A previously healthy 32-year-old female with acute VKH is on oral prednisone 50 mg daily for two weeks. FFA and OCT findings are typical for VKH, with a few cells in the anterior chamber. Repeat OCT shows significant improvement, with only subfoveal fluid. However, the patient reports worsening vision, and progress within a few days, her visual acuity drops from 20/50 to HM in both eyes, without having received any other immunosuppressive agents. Orbital and brain MRI w/o contrast are unremarkable. CBC and basic metabolic panel show no abnormalities. Serum AQP4 and MOG antibodies are negative. Syphilis, HIV, ACE, and ANA are also negative. Chest x-ray is normal. The uveitis specialist added mycophenolate later. 

When I saw the patient, visual acuity was HM in both eyes, both pupils were 4 mm with no reaction to light, the anterior chamber was quiet, and the fundus appeared normal. A full-field ERG showed nearly undetectable waveforms. I ordered anti-retinal antibodies but the results are still pending. I am considering IVMP 1 g, but I'm not sure whether steroid pulse therapy will be effective in her case. Should PLEX or IVIG be prioritized instead? Is a PET-CT also indicated? 

Any input is welcome.

Thanks!

Hi Dear All，

I have a patient for whom I would appreciate your opinions. 

A previously healthy 32-year-old female with acute VKH is on oral prednisone 50 mg daily for two weeks. FFA and OCT findings are typical for VKH, with a few cells in the anterior chamber. Repeat OCT shows significant improvement, with only subfoveal fluid. However, the patient reports worsening vision, and progress within a few days, her visual acuity drops from 20/50 to HM in both eyes, without having received any other immunosuppressive agents. Orbital and brain MRI w/o contrast are unremarkable. CBC and basic metabolic panel show no abnormalities. Serum AQP4 and MOG antibodies are negative. Syphilis, HIV, ACE, and ANA are also negative. Chest x-ray is normal. The uveitis specialist added mycophenolate later. 

When I saw the patient, visual acuity was HM in both eyes, both pupils were 4 mm with no reaction to light, the anterior chamber was quiet, and the fundus appeared normal. A full-field ERG showed nearly undetectable waveforms. I ordered anti-retinal antibodies but the results are still pending. I am considering IVMP 1 g, but I'm not sure whether steroid pulse therapy will be effective in her case. Should PLEX or IVIG be prioritized instead? Is a PET-CT also indicated? 

Any input is welcome.

Thanks!

Hi Dear All，

I have a patient for whom I would appreciate your opinions. 

A previously healthy 32-year-old female with acute VKH is on oral prednisone 50 mg daily for two weeks. FFA and OCT findings are typical for VKH, with a few cells in the anterior chamber. Repeat OCT shows significant improvement, with only subfoveal fluid. However, the patient reports worsening vision, and progress within a few days, her visual acuity drops from 20/50 to HM in both eyes, without having received any other immunosuppressive agents. Orbital and brain MRI w/o contrast are unremarkable. CBC and basic metabolic panel show no abnormalities. Serum AQP4 and MOG antibodies are negative. Syphilis, HIV, ACE, and ANA are also negative. Chest x-ray is normal. The uveitis specialist added mycophenolate later. 

When I saw the patient, visual acuity was HM in both eyes, both pupils were 4 mm with no reaction to light, the anterior chamber was quiet, and the fundus appeared normal. A full-field ERG showed nearly undetectable waveforms. I ordered anti-retinal antibodies but the results are still pending. I am considering IVMP 1 g, but I'm not sure whether steroid pulse therapy will be effective in her case. Should PLEX or IVIG be prioritized instead? Is a PET-CT also indicated? 

Any input is welcome.

Thanks!

Hi Dear All，

I have a patient for whom I would appreciate your opinions. 

A previously healthy 32-year-old female with acute VKH is on oral prednisone 50 mg daily for two weeks. FFA and OCT findings are typical for VKH, with a few cells in the anterior chamber. Repeat OCT shows significant improvement, with only subfoveal fluid. However, the patient reports worsening vision, and progress within a few days, her visual acuity drops from 20/50 to HM in both eyes, without having received any other immunosuppressive agents. Orbital and brain MRI w/o contrast are unremarkable. CBC and basic metabolic panel show no abnormalities. Serum AQP4 and MOG antibodies are negative. Syphilis, HIV, ACE, and ANA are also negative. Chest x-ray is normal. The uveitis specialist added mycophenolate later. 

When I saw the patient, visual acuity was HM in both eyes, both pupils were 4 mm with no reaction to light, the anterior chamber was quiet, and the fundus appeared normal. A full-field ERG showed nearly undetectable waveforms. I ordered anti-retinal antibodies but the results are still pending. I am considering IVMP 1 g, but I'm not sure whether steroid pulse therapy will be effective in her case. Should PLEX or IVIG be prioritized instead? Is a PET-CT also indicated? 

Any input is welcome.

Thanks!

Hi Dear All，

I have a patient for whom I would appreciate your opinions. 

A previously healthy 32-year-old female with acute VKH is on oral prednisone 50 mg daily for two weeks. FFA and OCT findings are typical for VKH, with a few cells in the anterior chamber. Repeat OCT shows significant improvement, with only subfoveal fluid. However, the patient reports worsening vision, and progress within a few days, her visual acuity drops from 20/50 to HM in both eyes, without having received any other immunosuppressive agents. Orbital and brain MRI w/o contrast are unremarkable. CBC and basic metabolic panel show no abnormalities. Serum AQP4 and MOG antibodies are negative. Syphilis, HIV, ACE, and ANA are also negative. Chest x-ray is normal. The uveitis specialist added mycophenolate later. 

When I saw the patient, visual acuity was HM in both eyes, both pupils were 4 mm with no reaction to light, the anterior chamber was quiet, and the fundus appeared normal. A full-field ERG showed nearly undetectable waveforms. I ordered anti-retinal antibodies but the results are still pending. I am considering IVMP 1 g, but I'm not sure whether steroid pulse therapy will be effective in her case. Should PLEX or IVIG be prioritized instead? Is a PET-CT also indicated? 

Any input is welcome.

Thanks!

Hi Dear All，

I have a patient for whom I would appreciate your opinions. 

A previously healthy 32-year-old female with acute VKH is on oral prednisone 50 mg daily for two weeks. FFA and OCT findings are typical for VKH, with a few cells in the anterior chamber. Repeat OCT shows significant improvement, with only subfoveal fluid. However, the patient reports worsening vision, and progress within a few days, her visual acuity drops from 20/50 to HM in both eyes, without having received any other immunosuppressive agents. Orbital and brain MRI w/o contrast are unremarkable. CBC and basic metabolic panel show no abnormalities. Serum AQP4 and MOG antibodies are negative. Syphilis, HIV, ACE, and ANA are also negative. Chest x-ray is normal. The uveitis specialist added mycophenolate later. 

When I saw the patient, visual acuity was HM in both eyes, both pupils were 4 mm with no reaction to light, the anterior chamber was quiet, and the fundus appeared normal. A full-field ERG showed nearly undetectable waveforms. I ordered anti-retinal antibodies but the results are still pending. I am considering IVMP 1 g, but I'm not sure whether steroid pulse therapy will be effective in her case. Should PLEX or IVIG be prioritized instead? Is a PET-CT also indicated? 

Any input is welcome.

Thanks!

Hi Dear All，

I have a patient for whom I would appreciate your opinions. 

A previously healthy 32-year-old female with acute VKH is on oral prednisone 50 mg daily for two weeks. FFA and OCT findings are typical for VKH, with a few cells in the anterior chamber. Repeat OCT shows significant improvement, with only subfoveal fluid. However, the patient reports worsening vision, and progress within a few days, her visual acuity drops from 20/50 to HM in both eyes, without having received any other immunosuppressive agents. Orbital and brain MRI w/o contrast are unremarkable. CBC and basic metabolic panel show no abnormalities. Serum AQP4 and MOG antibodies are negative. Syphilis, HIV, ACE, and ANA are also negative. Chest x-ray is normal. The uveitis specialist added mycophenolate later. 

When I saw the patient, visual acuity was HM in both eyes, both pupils were 4 mm with no reaction to light, the anterior chamber was quiet, and the fundus appeared normal. A full-field ERG showed nearly undetectable waveforms. I ordered anti-retinal antibodies but the results are still pending. I am considering IVMP 1 g, but I'm not sure whether steroid pulse therapy will be effective in her case. Should PLEX or IVIG be prioritized instead? Is a PET-CT also indicated? 

Any input is welcome.

Thanks!