The authors report a case of acute Vogt-Koyanagi-Harada syndrome with massively impaired perfusion in the Sattler's layer on optical coherence tomography angiography (OCTA). The hypoperfusion fully resolved during a period of 4 weeks and correlated well with hypofluorescent spots on indocyanine green angiography. This is the first time reduced perfusion in Sattler's layer has been observed on OCTA. This finding may aid further understanding of the pathology underlying VKH syndrome and indicates that evaluation of deeper choroidal layers like Sattler's layer may be of importance for disease monitoring and predicting prognosis in choroidal diseases. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:639-642.].
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