Vogt-Koyanagi-Harada-Like Disease Associated With Drug Reaction With Eosinophilia and Systemic Symptoms Syndrome

Purpose: To report a rare case of Vogt-Koyanagi-Harada disease (VKH)-like uveitis following drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome associated with human herpesvirus 6 viremia. Methods: A single case was reviewed. Results: A 34-year-old man presented with bilateral blurred vision and photophobia 3 months after an episode of DRESS secondary to antipsychotic medications. Ocular examination revealed bilateral anterior chamber and vitreous inflammation, serous macular retinal detachments, optic disc edema, and bacillary detachment in the left eye. Diagnostic testing was negative for infectious and inflammatory causes but demonstrated eosinophilia. A diagnosis of VKH-like disease secondary to DRESS was made. Systemic corticosteroid and steroid-sparing therapies were initiated, resulting in complete resolution of symptoms and clinical findings over 8 months. Conclusions: VKH-like disease may rarely be triggered by DRESS syndrome, although this association has not been previously reported in the ophthalmic literature. Further research is necessary to understand the relationship between these entities and the role of human herpesvirus 6 in their pathogenesis.