Cobo L M, Haynes B F
Ophthalmology. 1984 Aug;91(8):903-7. doi: 10.1016/s0161-6420(84)34215-4.
We evaluated the ocular manifestations of Cogan's syndrome in 13 consecutive patients. The most frequent and earliest ocular finding was bilateral peripheral subepithelial keratitis consisting of faint, nummular lesions. The subepithelial keratitis was responsive to topical administration of corticosteroids. Peripheral subepithelial keratitis was seen in four patients and strongly suspected on review of history in three additional patients. Deep stromal keratitis was seen in two patients, while only one patient developed classic findings of Cogan's syndrome, ie. interstitial keratitis with vascularization. Additionally, five patients presented with noncorneal ocular inflammatory disease and deafness (atypical Cogan's syndrome). Early subepithelial keratitis in Cogan's syndrome may be mistakenly diagnosed as trival ocular inflammatory disease, and suppressed by topical corticosteroids, resulting in delayed diagnosis of Cogan's syndrome in the absence of classic corneal findings. Early diagnosis of Cogan's syndrome is important inasmuch as prompt treatment of cochlear symptoms with systemic corticosteroids may prevent or ameliorate deafness.
我们评估了连续13例Cogan综合征患者的眼部表现。最常见且最早出现的眼部表现是双侧周边上皮下角膜炎，表现为轻微的钱币状病变。上皮下角膜炎对局部应用皮质类固醇有反应。4例患者出现周边上皮下角膜炎，另有3例患者经病史回顾强烈怀疑有该病变。2例患者出现深层基质角膜炎，而只有1例患者出现了Cogan综合征的典型表现，即伴有血管化的间质性角膜炎。此外，5例患者表现为非角膜性眼部炎症疾病和耳聋（非典型Cogan综合征）。Cogan综合征早期的上皮下角膜炎可能被误诊为轻微的眼部炎症疾病，并被局部皮质类固醇抑制，导致在没有典型角膜表现的情况下Cogan综合征的诊断延迟。Cogan综合征的早期诊断很重要，因为用全身性皮质类固醇及时治疗耳蜗症状可能预防或改善耳聋。
