Syndrome of nonsyphilitic Interstitial Keratitis and Vestibulcauditory symptoms: Cogan's Syndrome

ABSTRACT

The syndrome of nonsyphilitic interstitial keratitis associated with vestibulcauditory symptoms (tinnitus, vertigo, nystagmus and progressive deafness) was described by Dr. Cogan in 1945. Since then, numerous cases of this clinical entity have been reported elsewhere in the world. Recently the author experienced one case of Cogan's syndrome in our ophthalmologic OPD for the first time in Korea. The 45 years old male patient, looking very well on gross appearance, was admitted to ENT ward with sudden onset of vertigo, tinnitus and progressive deafness under the diagnosis of Meniere's disease on May 14,1976. Two month later, on July 6, 1976, the visual acuity in his left eye had suddenly deteriorated from 1.2 to 0.6. Under the slit lamp microscopic examination, mild infiltration in the corneal stroma and almost total pcsterior synechia were detected, and a few inflammatory cells were found in anterior chamber but not observed agueous flares. Several fine keratic precipitates were adhered on the lower one half of the posterior corneal surface as a linear apperance. The patient was treated by local instillation of 1% Atropine, 10% Phenylephrine and 3%. Dexamethasone, and also 1% Depomedrol was injected subconjunctivally. Oral administration of Dexamethasone, Vitamine B complex, INH and Chloramphenicol were combined. Thereafter those ocular symptoms had gradually improved, and recently his visual acuity has recovered to normal level (OS 1.2). The vestibuloauditory symptoms just as tinnitus and vertigo were also disappeared, where as moderate deafness has been still remained.