Internal Limiting Membrane Folds as a Presenting Sign in Acute Initial-Onset Vogt-Koyanagi-Harada Disease: A Case Report.

PURPOSE: To report a case of initial-onset acute Vogt-Koyanagi-Harada (VKH) presenting with internal limiting membrane (ILM) folds as the initial clinical sign. METHODS: This is a retrospective case review. RESULTS: A 36-year-old woman with a recent history of periorbital injection of cosmetic filler who presented with sudden blurred vision in the right eye of a few hours duration. Initial fundus examination revealed only ILM folds in the right eye. Next day, the patient developed the full ophthalmic clinical picture of initial-onset acute VKH disease. Multimodal imaging showed features of ILM undulations and acute VKH disease. Uveitis was treated successfully with systemic corticosteroids combined with mycophenolate mofetil. The patient had complete resolution of posterior segment inflammation and exudative retinal detachment. CONCLUSION: ILM folds/undulations can be one of the early signs in acute VKH disease, and may serve as an important early clinical clue for this diagnosis.

Educational and Behavioral Models for Promoting Health in Saudi Arabia: A Theoretical Overview.

In recent years, the field of environmental health promotion gained new prominence as awareness of physical environmental stressors and exposures escalated in Saudi Arabia. Although, several theories and conceptual models are routinely used for guiding health education and promotion interventions, they are rarely applied to environmental health issues in Saudi Arabia. This study theoretically reviews the educational and behavioral models for promoting health in Saudi Arabia. This study examines how education and behavioral models can reduce exposure to environmental health risks. In particular, this article describes the application of ecological theory with regard to its theoretical, analytical, and methodological challenges to future research in educational and behavioral studies. The implications of ecological theory are discussed for environmental health promotion. Ecological theory can further demonstrate the dimensions of health behaviors such as procedures for changing them. Health behaviors are also affected by many forces such as physical and social environments. This theory can assist planners in identifying the most appropriate target audiences, methods to improve change, and consequences for assessment. This theory is also important in including social, cultural, and physical factors that affect health consequences, which include factors such as social cohesion, behavioral patterns, emotional wellbeing, genetic heritage, and developmental maturation.