Hosseini Seyedeh Maryam, Gharouni Ahmad, Motamed Shariati Mehrdad
Eye Research Center, Mashhad University of Medical Sciences Mashhad Iran.
Clin Case Rep. 2023 Sep 4;11(9):e7879. doi: 10.1002/ccr3.7879. eCollection 2023 Sep.
Harada disease could uniquely present with only unilateral symptoms, as was seen in our patient. However, multimodal imaging including ICG angiography could show bilateral involvement. Considering the immunomodulatory effects of Cannabis, the absence of inflammatory findings and the unusual presentation of the disease, in our case, may have been caused by the use of marijuana.
To report a patient addicted to marijuana with the diagnosis of Vogt-Koyanagi-Harada (VKH) disease with a unilateral presentation. A 24-year-old man presented to us with painless decreased vision in his right eye (RE) and photophobia 3 days ago. No history of significant family or past medical history was documented. Spectral-domain optical coherence tomography (SD-OCT) of the RE showed multiple areas of subretinal fluid in the macula. Indocyanine green angiography (ICGA) revealed round hypocyanescent dark dots (HDD) of similar size, evenly distributed in both eyes. With the diagnosis of VKH disease, anti-inflammatory treatment was started. To our knowledge, this is the first reported case of suspected VKH in a patient with marijuana overuse. Regarding the complex effects of tetrahydrocannabinol (THC), the active ingredient of marijuana, on the vascular and immune systems, reaching a definite conclusion is not possible. This report shows the value of multimodal imaging in patients with unusual presentations.
原田病可能仅表现为单侧症状，就像我们的患者那样。然而，包括吲哚菁绿血管造影在内的多模态成像可显示双侧受累。考虑到大麻的免疫调节作用，在我们的病例中，炎症表现的缺失以及疾病的不寻常表现可能是由大麻使用所致。
报告一例吸食大麻成瘾且诊断为Vogt-小柳-原田（VKH）病的单侧表现患者。一名24岁男性3天前因右眼无痛性视力下降和畏光前来就诊。无显著家族病史或既往病史记录。右眼的频域光学相干断层扫描（SD-OCT）显示黄斑区多个视网膜下液区域。吲哚菁绿血管造影（ICGA）显示双眼有大小相似、均匀分布的圆形低荧光暗点（HDD）。诊断为VKH病后，开始进行抗炎治疗。据我们所知，这是首例报告的大麻过度使用患者疑似VKH病的病例。鉴于大麻的活性成分四氢大麻酚（THC）对血管和免疫系统的复杂影响，无法得出明确结论。本报告显示了多模态成像在表现不寻常患者中的价值。
