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

Area of Science:

• Ophthalmology
• Rheumatology
• Autoimmune Diseases

Background:

• Cogan's syndrome is a rare autoimmune vasculitis presenting with ocular and audiovestibular symptoms.
• Auditory symptoms often mimic Meniere's syndrome, and untreated disease can lead to sensorineural hearing loss.
• Atypical Cogan's syndrome can present with severe ocular complications.

Observation:

• This report details a rare case of uncontrolled intraocular pressure and choroidal effusion in a patient with atypical Cogan's syndrome.
• The patient presented with visual disturbances, ocular pain, hearing loss, acute renal failure, and fever.
• Ocular examination revealed anterior chamber inflammation, closed-angle glaucoma, and choroidal effusion.

Findings:

• Intraocular pressure remained uncontrolled despite topical and systemic medications.
• Surgical intervention (bilateral valve implant) was required to manage the glaucoma.
• Systemic corticosteroid therapy led to the resolution of choroidal effusion.

Implications:

• Cogan's syndrome can precipitate angle-closure glaucoma with choroidal effusion.
• Patients with short axial length and shallow anterior chambers are at higher risk.
• This case highlights the importance of recognizing and managing ocular manifestations in atypical Cogan's syndrome.