Abstract
Purpose
To report on a patient affected by bilateral intermediate uveitis (IU) as the initial sign of an uveomeningitic syndrome.
Methods
Thorough history, physical examination and ancillary laboratory and radiological testing were performed in this observational case study.
Results
A 23-year-old Caucasian man developed bilateral IU, primarily diagnosed as “idiopathic” since a detailed etiologic work-up was not indicative of underlying disease. Seven months later, he presented with poliosis and vitiligo. Lumbar puncture revealed cerebrospinal fluid pleocytosis. Optical coherence tomography showed bilateral subclinical macular edema (ME). The visual acuity was still 20/20 in both eyes. Clinical, laboratory and radiological results did not fit into any known syndrome.
Conclusions
According to all the tests performed, the disease in our patient is a uveomeningitic disease with IU and ME which could be interpreted as an atypical form of Vogt–Koyanagi–Harada disease or a new uveomeningitic syndrome because there is no evidence for any other known disease.
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References
Gass JDM (1987) Stereoscopic atlas of macular diseases: diagnosis and treatment, 3rd edn. Mosby, St Louis, p 150
Keino H, Goto H, Usui M (2002) Sunset glow fundus in Vogt-Koyanagi-Harada disease with or without chronic ocular inflammation. Graefes Arch Clin Exp Ophthalmol 240:878–882
Nordlund JJ, Todes Taylor N, Albert DM, Wagoner MD, Lerner AB (1981) The prevalence of vitiligo and poliosis in patients with uveitis. J Am Acad Dermatol 4:528–536
Russel WR, Holland GN, Rao NA, Tabbara KF, Ohno S, Arellanes-Garcia L, Pivetti-Pezzi P, Tessler HH, Usui M (2001) Revised diagnostic criteria for Vogt-Koyanagi-Harada disease: report of an international committee on nomenclature. Am J Ophthalmol 131:647–652
Rutzen AR, Ortega-Larrocea G, Frambach DA, Rao NA (1995) Macular edema in chronic Vogt-Koyanagi-Harada syndrome. Retina 15:475–479
Snyder DA, Tessler HH (1980) Vogt-Koyanagi-Harada syndrome. Am J Ophthalmol 90:69–75
Stavrou P, Foster CS (2001) Sarcoidosis. In: Foster CS, Vitale AT (eds) Diagnosis and treatment of uveitis. Saunders, Philadelphia, pp 710–725
Tesavibul N (2001) Vogt-Koyanagi-Harada syndrome. In: Foster CS, Vitale AT (eds) Diagnosis and treatment of uveitis. Saunders, Philadelphia, pp 748–756
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This study received no funding, and the authors had no financial or proprietary interest in it.
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Kodjikian, L., Seve, P., Le Hoang, P. et al. Atypical Vogt–Koyanagi–Harada disease or new uveomeningitic syndrome?. Graefe's Arch Clin Exp Ophthalmol 243, 263–265 (2005). https://doi.org/10.1007/s00417-004-1002-z
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DOI: https://doi.org/10.1007/s00417-004-1002-z