Vogt-Koyanagi-Harada (VKH) disease is a granulomatous panuveitis with characteristic systemic manifestations. The MOST specific early ocular finding in the acute uveitic phase is:

• A Exudative (non-rhegmatogenous) bilateral choroidal detachments and retinal detachment with disc hyperaemia ✓
• B Mutton-fat keratic precipitates in the inferior corneal endothelium
• C Snowball vitreous opacities and snowbanking at the pars plana
• D Retinal vasculitis with arterial sheathing and occlusion

Explanation

In the acute uveitic phase of VKH, diffuse choroidal inflammation leads to exudative retinal detachments — often bilateral, bullous, and non-rhegmatogenous — along with disc hyperaemia and posterior chorioretinal thickening visible on OCT and FFA (multiple discrete areas of hyperfluorescence with late pooling under the elevated retina, the 'Dalen-Fuchs nodule equivalent'). VKH is distinguished from sympathetic ophthalmia by bilateral onset, preceding systemic prodrome (meningismus, hearing loss, vitiligo/poliosis), and no history of penetrating trauma. Snowball opacities/snowbanking are features of pars planitis/intermediate uveitis (often sarcoidosis or MS-associated).

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.