Relapse of Vogt-Koyanagi-Harada Disease during Interferon-α and Ribavirin Therapy in a Case of Chronic Viral Hepatitis C

Abstract

A 60-year-old woman, who had been diagnosed with and treated for Vogt-Koyanagi-Harada (VKH) disease 17 years before, was receiving pegylated interferon-? and ribavirin therapy for chronic hepatitis C virus. Three weeks after the start of therapy, she complained of visual blurring, eye pain, and an increased hearing loss. Based on a slit lamp and fundus examination, she was diagnosed with a relapse of VKH disease. After discontinuation of the pegylated interferon-α and ribavirin therapy and administration of corticosteroid therapy, her visual acuity returned to 1.0 in both eyes without ocular inflammation, and remained stable thereafter. When interferon therapy is administered to hepatitis C virus patients, those who also have a history of VKH disease must be closely monitored for ophthalmologic complications.

Keywords: Chronic hepatitis C virus; Interferon-α; Vogt-Koyanagi-Harada disease.

Fig. 1

Fluorescein angiographic features of the patient at the initial onset of VKH disease in April 1991. Fluorescein angiography shows multiple locations of pinpoint subretinal leakage and serous retinal detachment. a Right eye. b Left eye.

Fig. 2

Fundus photographs of the patient at the second onset of VKH disease in June 2008 after the start of PEG-IFN and ribavirin therapy. Both eyes show a sunset appearance with serous detachment (a, b). Fluorescein angiography shows multiple locations of pinpoint subretinal leakage corresponding to serous retinal detachment (c, d). a, c Right eye. b, d Left eye.