A Case of Vogt-Koyanagi-Harada Disease: Diagnosis Based on the Presence of Vitiligo and Sunset Glow Fundus Without Ocular Symptoms

Vogt-Koyanagi-Harada disease is an autoimmune disease affecting melanocytes. We report a case of Vogt-Koyanagi-Harada disease where the diagnosis was based on the presence of vertigo, vitiligo, and sunset glow fundus without ocular symptoms. The patient was a 68-year-old woman with a history of type 1 diabetes mellitus who developed vertigo three months prior and vitiligo on the face and arms two months prior. An ophthalmic examination revealed sunset glow fundus with numerous depigmented chorioretinal scars. Keratic precipitates were observed; however, no cells were observed in the anterior chamber. The patient had been examined by an ophthalmologist five years prior for a thorough evaluation of diabetic retinopathy; at that time, the fundus was normal in color. Based on the vertigo, vitiligo, and fundus findings, the patient was diagnosed as having convalescent Vogt-Koyanagi-Harada disease. Physicians should be aware that Vogt-Koyanagi-Harada disease is a potential cause of systemic symptoms, including vertigo, hearing loss, headache, nausea, and vitiligo.