We read with interest the recent study by Ishihara et al describing the features of acute Vogt-Koyanagi-Harada (VKH) disease as imaged using spectral domain optical coherence tomography (OCT) with B-scan averaging. VKH disease is a diffuse granulomatous inflammatory disorder of the uvea that results in multifocal serous detachment of the retina. In their study, the authors hypothesize that the acute fluid exudation characteristic of the disease results in splitting of the photoreceptor outer...