In the study, researchers investigated the utility of F-fludeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) for the diagnosis of Vogt–Koyanagi–Harada (VKH) syndrome with AITD

Vogt–Koyanagi–Harada (VKH) disease is a bilateral granulomatous panuveitis with exudative retinal detachments and papilloedema. Systemically, it may be presented with multisystemic symptoms such as meningismus (neurological manifestation), tinnitus, hearing impairment, vertigo, alopecia areata, and poliosis (integumentary manifestation). 

The diagnostic criteria for VKH syndrome can be categorized into three sets including probable VKH (with only ocular manifestation), incomplete VKH (an ocular finding with neurological and integumentary manifestation), and complete VKH (the ocular finding with neurological and integumentary manifestation).

The classification of VKH depends on how much of the presentations fulfilled these criteria. In previous reports, VKH syndrome has been shown to associate with autoimmune thyroid disease (AITD). The AITD is characterized by the dysfunction of thyroid tissue by antibody-mediated immune inflammation and the aetiology of AITD is multifactorial and occurs predominantly in females.

Positron emission tomography (PET) is a functional imaging technique for the detection of malignancy. It is also widely used in inflammatory diseases and other fields of medicine. The reagent 18F-fludeoxyglucose (FDG) is a glucose analogue that is an important imaging modality for the detection of tumour staging, restaging, recurrence; and the monitoring of treatment response.

A 55-year-old woman without the history of ocular trauma suffered from a chronic headache. She was presented with a painful blurred vision of both eyes with a headache for 2 weeks. Ophthalmic evaluations revealed panuveitis, exudative retinal detachment, and papilloedema in both eyes. The clinical symptoms and presentations are compatible with the diagnosis of VKH syndrome.

Other examinations for intraocular infection, malignancy, and lupus choroidopathy were of negative results. The result of contrast-enhanced computed tomography (CT) of the brain was normal. Due to the history of cancer in the patient's families, an 18F-FDG PET/CT whole-body scan was performed.

The result indicated a focal of 2-fluoro-2-deoxy-d-glucose (FDG) uptake at the right upper lobe of the thyroid. Therefore, the patient's thyroid function was examined and the result indicated euthyroidism with detectable thyroid peroxidase/thyroglobulin antibodies.

Symptoms of papillitis and serous retinal detachment of VKH syndrome was relieved after steroid treatment LESSONS. F-fludeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) can be used for the effective diagnosis of VKH syndrome with AITD.

Positron emission tomography/computed tomography scan of Vogt-Koyanagi-Harada syndrome with associated autoimmune thyroid disease, they conclude.