Jaewon Phee
Brighton and Sussex Medical School, UK
Title: An unusual presentation of Roth spots in Cogan’s Syndrome
Biography
Biography: Jaewon Phee
Abstract
Introduction
Cogan’s syndrome is a rare chronic inflammatory disease that can lead to blindness, deafness and even death. It is described as “a syndrome of non-syphilitic interstitial keratitis (IK) and Ménière-like audiovestibular dysfunction”1. The cause is still unknown and the diagnosis is usually made on clinical grounds, as there is no specific investigation for the disease. Here we present a case of Cogan’s syndrome with a rare ocular manifestation.
Purpose
To present a case of Cogan’s syndrome with a rare ocular manifestation
Results
A 32-year-old man presented to the emergency department with a 10-day history of blurred vision and pain in his right eye. Preceding this, he had a two-week history of deteriorating balance and nausea.
On examination of his right eye, his visual acuity was 6/60. He had anterior chamber inflammatory cells with associated keratic precipitates, vitreous cells and multiple Roth spots. He later developed reduced hearing in both ears and a diagnosis of Cogan’s syndrome was made. He was promptly treated with oral prednisolone and cyclophosphamide.
A week later, the anterior chamber activity had resolved and his vitreous cells had completely settled. His Roth spots had also faded. However, he had ongoing balance issues and had developed bilateral moderate sensorineural hearing loss, tinnitus and true vertigo.
The patient responded well to systemic immunosuppression and two weeks later his visual acuity had improved to 6/18 and he had recovered most of his hearing.
Conclusions
This is a case of Roth spots caused by Cogan’s syndrome, an association that has not previously been described.