Purpose: To report on a patient with unilateral Vogt-Koyanagi-Harada (VKH) disease who developed varicella zoster-associated acute retinal necrosis after corticosteroid pulse therapy for the VKH disease. Methods: Observational case report. Results: A 36-year-old Japanese man was diagnosed with incomplete VKH disease despite having only unilateral changes. After corticosteroid pulse therapy, the same eye developed acute retinal necrosis. Polymerase chain reaction of an aqueous humor specimen showed DNA of the varicella zoster virus. Seven days after intravenous acyclovir, the retinitis disappeared. Conclusion: We encountered a rare case of unilateral VKH disease that developed acute retinal necrosis during corticosteroid pulse therapy. Acute retinal necrosis can develop during corticosteroid pulse therapy for VKH disease.
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