Recurrent Vogt–Koyanagi–Harada disease with sensorineural hearing loss and choroidal thickening

Int Ophthalmol. 2014 Jun;34(3):679-84. doi: 10.1007/s10792-013-9849-9.

Abstract

We report a case of Vogt–Koyanagi–Harada (VKH) disease that recurred with sensorineural hearing loss and choroidal thickening. We measured the choroidal thickness using enhanced-depth imaging optical coherence tomography (EDI-OCT) in a patient with VKH during corticosteroid-tapering therapy. A71-year-old male presented with fever, headache, and anorthopia associated with wavy choroidal folds and aserous retinal detachment (SRD). The EDI-OCT images showed choroidal thickening ([600 l m at the subfovea), and he was diagnosed with VKH disease. After treatment with pulsed intravenous methylprednisolone, the choroidal folds and SRD resolved and the choroidal thickness decreased. About 6 months after subsequent treatment with an oral corticosteroid started, headache, tinnitus, and sensorineural hearing loss developed, and increased choroidal thickness was observed without other evidence of increased ocular inflammation. A high-dose corticosteroid was injected and tapered, and the sensorineural hearing loss improved immediately and the choroidal thickness decreased. In the current case, sensorineural hearing loss occurred with recurrent VKH disease;however, there were no ocular inflammatory signs except for rebound choroidal thickening. Measuring the choroidal thickness using EDI-OCT can sensitively identify recurrent VKH disease.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Choroid Diseases / etiology*
  • Hearing Loss, Sensorineural / etiology*
  • Humans
  • Male
  • Recurrence
  • Uveomeningoencephalitic Syndrome / complications*