Intermediate uveitis associated with Cogan's syndrome

Abstract Purpose: To describe a case of intermediate uveitis and optic neuritis associated with Cogan's syndrome. Methods: A case report. Results: A 29‐year‐old white Caucasian female was referred to our department for decreased vision in her left eye (LE). Previous medical history revealed relapsing intermediate uveitis and optic neuritis in the LE for 5 years and a sensio‐neural hearing loss a year earlier. On presentation, her ophthalmological examination revealed best corrected visual acuity in the LE of 6/60 with a relative afferent pupillary defect. Slit lamp examination revealed a clear cornea, 0.5+ cells in the anterior chamber and 3+ cells in the vitreous. Fundus examination showed an optic disc atrophy. Examination of the right eye was unremarkable. Examination by the internist revealed palmar erythematous lesions. Laboratory work‐up was negative for infectious diseases. Testing for antinuclear antibodies, antineutrophil cytoplasmic antibodies and rheumatoid factor were negative. The diagnosis of atypical Cogan's syndrome was made based on the association of atypical ophthalmological manifestations and typical audio‐vestibular manifestations. The patient was treated with oral prednisone and azathioprine. Conclusions: Optic neuritis may rarely be an ocular manifestation of Cogan's syndrome.