Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-24T12:45:11.777Z Has data issue: false hasContentIssue false

Auditory and vestibular manifestations of Vogt–Koyanagi–Harada disease

Published online by Cambridge University Press:  30 September 2010

S Al Dousary*
Affiliation:
Department of Otorhinolaryngology, King Abdul Aziz University Hospital, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
*
Address for correspondence: Dr Surayie Al Dousary, Department of Otorhinolaryngology, Faculty of Medicine, King Saud University, Airport Rd, PO Box 245, Riyadh 11411, KSA Fax: +96614775748 E-mail: [email protected]

Abstract

Introduction and aims:

Vogt–Koyanagi–Harada disease is a chronic disorder involving the eye and the central nervous, auditory, vestibular and integumentary systems. This study aimed to determine the auditory and vestibular manifestations of this disease.

Methods:

Twenty-four patients diagnosed with Vogt–Koyanagi–Harada disease were assessed for auditory and vestibular dysfunction.

Results:

Uveitis presents in all cases. Sensory hearing loss was present in 50 per cent of cases, tinnitus in 42 per cent, vertigo in 17 per cent and headache in 17 per cent. Nine patients received systemic steroids. Six patients who were treated early regained their hearing, but three patients whose treatment was delayed did not. One patient with bilateral profound hearing loss underwent cochlear implantation, and achieved excellent post-implantation hearing.

Conclusion:

There is a high incidence of cochlear and vestibular end-organ involvement in patients with Vogt–Koyanagi–Harada disease. The adequacy and timing of treatment has a significant effect on the disease outcome. Vogt–Koyanagi–Harada disease appears to affect the inner ear end-organ. Patients who develop bilateral profound sensory hearing loss are suitable candidates for cochlear implantation.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Ibanez, HE, Grand, MG, Meredith, TA, Wippold, FJ. Magnetic resonance imaging findings in Vogt-Koyanagi-Harada Disease. Retina 1994;14:164–8CrossRefGoogle Scholar
2Forster, DJ, Cano, MR, Green, RL, Rao, NA. Echographic features of the Vogt-Koyanagi-Harada syndrome. Arch Ophthalmol 1990;108:1421–6CrossRefGoogle ScholarPubMed
3Sheu, SJ, Kou, HK, Chen, JF. Prognostic factors for Vogt-Koyanagi-Harada Disease. J Chin Med Assoc 2003;66:148–54Google ScholarPubMed
4Panitrungroung, T, Kulthanan, K, Chuenkongkaew, W. Vogt-Koyanagi-Harada syndrome: a case report and literature review. Thai J Dermatol 1999;15:208–14Google Scholar
5Kahn, M, Pepose, JS, Green, WR, Miller, J, Foos, RY. Immunocytologic findings in a case of Vogt-Koyanagi-Harada syndrome. Ophthalmology 1993;100:1191–8CrossRefGoogle Scholar
6Yamaki, K, Gocho, K, Hayakawa, K, Kondo, I, Sakuragi, S. Tyrosinase family proteins are antigens specific to Vogt-Koyanagi-Harada disease. J Immunol 2000;165:7323–9CrossRefGoogle ScholarPubMed
7Read, RW, Rao, NA. Utility of existing Vogt-Koyanagi-Harada syndrome diagnostic criteria at initial evaluation of the individual patient: a retrospective analysis. Ocul Immunol Inflamm 2000;8:227–34CrossRefGoogle ScholarPubMed
8Read, RW, Holland, GN, Rao, NA, Tabbara, KF, Ohno, S, Arellanes-Garcia, L et al. Perspective: revised criteria for Vogt-Koyanagi-Harada disease: report of an international committee on nomenclature. Am J Ophthalmol 2001;131:647–52CrossRefGoogle Scholar
9Yamaki, K, Sakuraqi, S. Application of revised diagnostic criteria for patients with Vogt-Koyanagi-Harada disease in Japanese patients. Jpn J Ophthalmol 2005;49:143–8CrossRefGoogle ScholarPubMed
10Hayasaka, S, Okabe, H, Takahashi, J. Systemic corticosteroid treatment in Vogt-Koyanagi-Harada disease. Graefes Arch Clin Exp Ophthalmol 1982;218:913CrossRefGoogle ScholarPubMed
11Freeman, WR, Chavis, PS, Tabbara, KF. Vogt-Koyanagi-Harada syndrome in children compared to adults. Acta Ophthalmol Scand 1998;76:723–6Google Scholar
12Yoshimoto, Y. Otoneurological observation and classification of Harada's disease presenting with aural symptoms, especially vertigo. Acta Otolaryngol (Stockh) 1995;519(suppl):114–17Google Scholar
13Seals, RL, Rise, EN. Vogt-Koyanagi-Harada syndrome. Arch Otolaryngol Head Neck Surg 1967;86:419–23Google Scholar
14Kimura, H, Ohashi, N, Aso, S, Watanabe, Y. Clinical study of the role of melanocytes in the inner ear of patients with Harada's disease. ORL J Otorhinolaryngol Relat Spec 1996;58:233–7CrossRefGoogle ScholarPubMed
15Maxwell, ON. Hearing loss in uveitis. Arch Otolaryngol 1963;78:138–42Google Scholar
16Read, RW, Accorinti, M, Bodaghi, B, Chee, SP, Fardeau, C, Goto, H et al. Evaluation of the effect on outcomes of the route of administration of corticosteroids in acute Vogt-Koyanagi-Harada disease. Am J Ophthalmol 2006;42:119–24Google Scholar
17Nussenblatt, RB, Palestine, AG, Chan, CC. Cyclosporine A therapy in the treatment of interocular inflammatory disease resistant to systemic corticosteroids and cytotoxic agents. Am J Ophthalmol 1983;96:275–82CrossRefGoogle Scholar
18Wakatsuki, Y, Kogure, M, Takahashi, Y, Oguro, Y. Combination therapy with cyclosporine A and steroid in severe case of Vogt-Koyanagi-Harada's disease. Jpn Ophthalmol 1988;32:358–60Google Scholar