Unilateral annular choroidal effusions as a rare presentation of harada disease.

PURPOSE:To report a rare case of Harada disease that initially presented as a unilateral ring of choroidal effusions. METHODS:Retrospective chart review. RESULTS:A 42-year-old Trinidadian woman presented with a serous retinal detachment overlying a unilateral ring of choroidal effusions in the absence of any systemic symptoms. Visual acuity was hand motion with a relative afferent pupillary defect. Biometry revealed an axial length of 21.12 mm and a thickened sclerochoroidal complex. Fluorescein angiography did not demonstrate pinpoint leakage or subretinal pooling classically seen in Harada disease. Oral steroids improved the visual acuity to 20/50, and laboratory testing and head imaging returned nonrevealing. After 2 months of incomplete steroidal treatment due to nonadherence, the patient represented with bilateral decreased visual acuity, anterior uveitis, serous detachments, and diffuse pinpoint leakage on fluorescein angiography consistent with the early stage of Harada disease. CONCLUSION:This is a case of a unilateral presentation of Harada disease with an impressive ring of choroidal effusions before developing a classic bilateral appearance. Possible contributions to the initial presentation include choroidal venous congestion in the setting of a borderline short eye and thickened sclerochoroidal complex.