Reactivation of previously controlled Vogt-Koyanagi-Harada disease more than 46 years following COVID-19 vaccination: a case study

J Int Med Res. 2024 Jan;52(1):3000605231221081. doi: 10.1177/03000605231221081.

Abstract

We report a case of Vogt-Koyanagi-Harada (VKH) disease that recurred 46 years after initial treatment. A 59-year-old woman presented with a 2-month history of bilateral vision blurring. She had received her third dose of coronavirus disease 2019 (COVID-19) vaccination 4 months before the onset of blurring. The best-corrected visual acuity (BCVA) was 1.0 in the right eye and 0.15 in the left eye at the initial visit. Iritis and synechia were observed between the lens and iris bilaterally. A sunset glow fundus was found in both eyes with no serous retinal detachments or disc hyperemia. The patient had a history of VKH disease and had been treated with whole-body corticosteroid administration at another hospital when she was 13 years old. The patient was diagnosed with VKH disease recurrence, and oral corticosteroid therapy and corticosteroid eyedrop treatment were initiated. The treatment response was good. At the time of this writing, recurrence had not been observed for 14 months, and the BCVA was 1.0 in both eyes. To our knowledge, this case represents the longest recorded interval of VKH disease recurrence in the literature to date. COVID-19 vaccination might be the cause of long-term well-controlled disease recurrence.

Keywords: Vogt–Koyanagi–Harada disease; case report; coronavirus disease 2019; iritis; recurrence; sunset glow fundus.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / therapeutic use
  • COVID-19 Vaccines* / adverse effects
  • COVID-19*
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Middle Aged
  • Uveomeningoencephalitic Syndrome* / chemically induced
  • Uveomeningoencephalitic Syndrome* / diagnosis
  • Uveomeningoencephalitic Syndrome* / drug therapy

Substances

  • Adrenal Cortex Hormones
  • COVID-19 Vaccines
  • Glucocorticoids