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Purpose: To compare clinical, angiographic, and optical coherence tomographic characteristics between eyeswith acute Vogt-Koyanagi-Harada (VKH) disease and eyes with acute bilateral central serous chorioretinopathy(CSC), and to demonstrate distinguishing features between the two diseases in confusing cases. Methods: The medical records of 35 patients with VKH disease and 25 patients with bilateral CSC were retrospectivelyreviewed. Characteristics according to slit-lamp biomicroscopy, ophthalmoscopy, fundus photography,fluorescein angiography, indocyanine green angiography, and spectral-domain optical coherence tomographywere compared between the two diseases. Results: Five of 35 patients (10 of 70 eyes, 14.3%) with VKH disease were initially misdiagnosed as CSC patients,and six of 25 patients (12 of 50 eyes, 24%) with bilateral CSC were initially misdiagnosed as patientswith VKH disease. Pigment epithelial detachment in CSC and optic disc hyperemia in VKH disease show thehighest positive predictive values of 100% for each disease. Conclusions: Optic disc hyperemia in VKH disease and pigment epithelial detachment in bilateral CSC are themost specific clinical manifestations of each disease at initial patient presentation.
