Advertisement

International Ophthalmology

, Volume 34, Issue 3, pp 679–684 | Cite as

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

  • Akihiro Ishibazawa
  • Reiko Kinouchi
  • Yoshiro Minami
  • Akihiro Katada
  • Akitoshi Yoshida
Case Report

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. A 71-year-old male presented with fever, headache, and anorthopia associated with wavy choroidal folds and a serous retinal detachment (SRD). The EDI-OCT images showed choroidal thickening (>600 μm 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.

Keywords

Vogt–Koyanagi–Harada disease Choroidal thickness Enhanced-depth imaging optical coherence tomography Sensorineural hearing loss 

Notes

Acknowledgments

The authors have no financial interest in any aspect of this report. Supported by a Grant-in-Aid for Young Scientists (B) 23791956 and 25861608 (A.I.), and Challenging Exploratory Research 23659803 (R.K.) from the Ministry of Education, Science, and Culture, Tokyo, Japan.

References

  1. 1.
    Moorthy RS, Inomata H, Rao NA (1995) Vogt–Koyanagi–Harada syndrome. Surv Ophthalmol 39:265–292PubMedCrossRefGoogle Scholar
  2. 2.
    Rao NA (2007) Pathology of Vogt–Koyanagi–Harada disease. Int Ophthalmol 27:81–85. doi: 10.1007/s10792-006-9029-2 PubMedCrossRefGoogle Scholar
  3. 3.
    Spaide RF, Koizumi H, Pozzoni MC (2008) Enhanced depth imaging spectral-domain optical coherence tomography. Am J Ophthalmol 146:496–500. doi: 10.1016/j.ajo.2008.05.032 PubMedCrossRefGoogle Scholar
  4. 4.
    Maruko I, Iida T, Sugano Y, Oyamada H, Sekiryu T, Fujiwara T, Spaide RF (2011) Subfoveal choroidal thickness after treatment of Vogt–Koyanagi–Harada disease. Retina 31:510–517. doi: 10.1097/IAE.0b013e3181eef053 PubMedCrossRefGoogle Scholar
  5. 5.
    Nakayama M, Keino H, Okada AA, Watanabe T, Taki W, Inoue M, Hirakata A (2012) Enhanced depth imaging optical coherence tomography of the choroid in Vogt–Koyanagi–Harada disease. Retina 32:2061–2069. doi: 10.1097/IAE.0b013e318256205a PubMedCrossRefGoogle Scholar
  6. 6.
    Nakai K, Gomi F, Ikuno Y, Yasuno Y, Nouchi T, Ohguro N, Nishida K (2012) Choroidal observations in Vogt–Koyanagi–Harada disease using high-penetration optical coherence tomography. Graefes Arch Clin Exp Ophthalmol 250:1089–1095. doi: 10.1007/s00417-011-1910-7 PubMedCrossRefGoogle Scholar
  7. 7.
    Read RW, 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 131:647–652PubMedCrossRefGoogle Scholar
  8. 8.
    Inomata H, Sakamoto T (1990) Immunohistochemical studies of Vogt–Koyanagi–Harada disease with sunset sky fundus. Curr Eye Res 9(Suppl):35–40PubMedCrossRefGoogle Scholar
  9. 9.
    Fong AH, Li KK, Wong D (2011) Choroidal evaluation using enhanced depth imaging spectral-domain optical coherence tomography in Vogt–Koyanagi–Harada disease. Retina 31:502–509. doi: 10.1097/IAE.0b013e3182083beb PubMedCrossRefGoogle Scholar
  10. 10.
    Damico FM, Kiss S, Young LH (2005) Vogt–Koyanagi–Harada disease. Semin Ophthalmol 20:183–190. doi: 10.1080/08820530500232126 PubMedCrossRefGoogle Scholar
  11. 11.
    Ondrey FG, Moldestad E, Mastroianni MA, Pikus A, Sklare D, Vernon E, Nusenblatt R, Smith J (2006) Sensorineural hearing loss in Vogt–Koyanagi–Harada syndrome. Laryngoscope 116:1873–1876. doi: 10.1097/01.mlg.0000234946.31603.fe PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Akihiro Ishibazawa
    • 1
    • 2
    • 4
  • Reiko Kinouchi
    • 1
    • 3
  • Yoshiro Minami
    • 1
    • 4
  • Akihiro Katada
    • 5
  • Akitoshi Yoshida
    • 1
  1. 1.Department of OphthalmologyAsahikawa Medical UniversityAsahikawaJapan
  2. 2.Department of Ocular Tissue EngineeringAsahikawa Medical UniversityAsahikawaJapan
  3. 3.Department of Medicine and Engineering Combined ResearchAsahikawa Medical UniversityAsahikawaJapan
  4. 4.Nayoro City General HospitalNayoroJapan
  5. 5.Department of Otolaryngology, Head and Neck SurgeryAsahikawa Medical UniversityAsahikawaJapan

Personalised recommendations