Atypical Cogan's Syndrome with Choroidal Effusion: A Case Report

Cogan's syndrome is a rare form of autoimmune vasculitis that manifests with ocular and audiovestibular symptoms. The clinical presentations of Cogan's syndrome can be classified as typical and atypical, and the auditory symptoms are classically similar to those seen in cases of Meniere's syndrome. Without treatment, Cogan's syndrome could become severe, resulting in sensorineural hearing loss in over 50% of patients. This report describes a rare case of uncontrolled intraocular pressure and choroidal effusion in a patient with atypical Cogan's syndrome. A 51-year-old woman was referred to our clinic on account of bilateral distortion of visual acuity and ocular pain following admission to the internal medicine department for bilateral hearing loss, acute renal failure, and fever. Upon ocular examination, we observed bilateral 2-3+ cells in the anterior chamber and closed-angle glaucoma, and choroidal effusion in the right eye. The intraocular pressure could not be controlled with topical and systemic medications, and a bilateral valve implant surgery was performed subsequently. Two weeks later, after systemic corticosteroid therapy, the choroidal effusion resolved. Cogan's syndrome can provoke angle-closure glaucoma with choroidal effusion in patients with a short axial length and shallow anterior chamber.