Recurrent Vogt–Koyanagi–Harada disease with sensorineural hearing loss and choroidal thickening
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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.
KeywordsVogt–Koyanagi–Harada disease Choroidal thickness Enhanced-depth imaging optical coherence tomography Sensorineural hearing loss
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.