Recurrent Vogt-Koyanagi-Harada disease with sensorineural hearing loss and choroidal thickening.
Recurrent Vogt-Koyanagi-Harada disease with sensorineural hearing loss and choroidal thickening.
复制标题
复发性 Vogt-Koyanagi-Harada 病伴有感音神经性听力损失和脉络膜增厚。
DOI：
10.1007/s10792-013-9849-9
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Yoshida A.
中科院分区：
文献类型：
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作者：
Ishibazawa A;Kinouchi R;Minami Y;Katada A;Yoshida A.
我们报告了一例 Vogt-Koyanagi-Harada (VKH) 病，该病复发并伴有感音神经性听力损失和脉络膜增厚。我们使用增强深度成像光学相干断层扫描 (EDI-OCT) 测量了一名 VKH 患者在皮质类固醇逐渐减量治疗期间的脉络膜厚度。一名 71 岁男性出现发烧、头痛和与波状脉络膜皱襞和浆液性视网膜脱离 (SRD) 相关的斜视。 EDI-OCT 图像显示脉络膜增厚（中央凹下>600 μm），他被诊断患有 VKH 病。脉冲静脉注射甲基泼尼松龙治疗后，脉络膜皱襞和 SRD 消失，脉络膜厚度减小。在开始后续口服皮质类固醇治疗后约 6 个月，出现头痛、耳鸣和感音神经性听力损失，并且观察到脉络膜厚度增加，但没有其他眼部炎症增加的证据。注射大剂量皮质类固醇并逐渐减量，感音神经性听力损失立即改善，脉络膜厚度减小。在本例中，感音神经性听力损失是由 VKH 疾病复发引起的；然而，除了脉络膜反跳增厚外，没有任何眼部炎症症状。使用 EDI-OCT 测量脉络膜厚度可以灵敏地识别复发性 VKH 疾病。
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.