The effect of high-altitude exposure on Vogt-Koyanagi-Harada syndrome: a case report

Vogt-Koyanagi-Harada (VKH) is a rare and complex autoimmune disease that primarily affects the eyes and the central nervous system. The underlying mechanism of this disease remains unclear, but it is closely related to genetic susceptibility, environmental factors, and abnormal immune responses. This report presents a case of VKH syndrome potentially associated with High-altitude exposure, It highlights that environmental factors may act as a catalyst for the onset of this disease. High altitude can cause retinal lesions from UV radiation and hypoxia, risking visual health. Limited data on VKH in these contexts emphasizes the need for caution among VKH patients traveling to high altitudes. A 31-year-old female experienced sudden blurred vision, eye swelling, pain, redness, headache, and tinnitus after a trip to Lhasa, Tibet, where she stayed at high altitude. She had no significant medical history and left the area after symptoms began. Examination showed low visual acuity, normal intraocular pressure, conjunctival injection, and retinal detachment. After diagnosis, she received high-dose steroid therapy, leading to significant improvement in her vision. High-altitude illness (HAI) arises from hypoxia above 2,500 m, causing symptoms like headaches and fatigue, and significantly impacts VKH syndrome through factors like UV radiation and tissue hypoxia. It may alter immune balance, posing risks for VKH patients in high-altitude areas. In the summary and reflection of this case, we recognized the complexity of VKH and its relationship with environmental factors. Altitude sickness may pose a serious threat to patients with VKH. It is recommended to avoid high-altitude areas (above 2500 m). As it may affect retinal health and cause complications such as vision problems, if it is necessary to go there, a protection plan should be formulated under the assessment of a doctor, and abnormal signs should be monitored. Protecting vision should be the top priority. The uniqueness of this VKH case offers new insights but also has limitations due to the small sample size and lack of a control group; future studies should increase sample size and perform multi-center epidemiological research on high-altitude exposure’s effects.