Harada-like Syndrome in a Chronic Hepatitis B Carrier: Case Report
10.21561/jor.2026.11.1.90
- Author:
Min Kook SIM
1
;
Sung Yeon JUN
Author Information
1. Department of Ophthalmology, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
- Publication Type:CASE REPORT
- From:
Journal of Retina
2026;11(1):90-95
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:To report a case of Harada-like syndrome occurring in a patient with chronic hepatitis B and compensated liver cirrhosis.Case summary: A 66-year-old man with hepatitis B surface antigen positivity and Child-Pugh A cirrhosis presented with a two- to three-day history of decreased vision in the right eye. Best-corrected visual acuity was 0.5 in the right eye and 1.0 in the left eye. Slit-lamp examination showed no anterior chamber or vitreous inflammation. Optical coherence tomography revealed a thicker choroid in the right eye in comparison to the left, along with choroidal folds and multifocal subretinal fluid (SRF) in the right eye. Wide-field fundus imaging revealed bilateral cotton-wool spots and serous retinal detachment in the right eye, while the left eye had no SRF. Fluorescein angiography demonstrated multifocal leakage and pooling, and Indocyanine green angiography revealed hypocyanescent spots consistent with choroidal inflammation in the right eye. Neurological symptoms such as headache, tinnitus, or meningismus were absent throughout the entire follow-up period, and infectious serologic tests were all negative. The patient was treated with oral prednisolone 50 mg/ day without antiviral prophylaxis, which was tapered to 25 mg over four weeks. Patient’s SRF and cotton-wool spots gradually resolved with visual improvement, and no hepatitis B virus (HBV) reactivation or systemic complications occurred.
Conclusions:This case represents the first reported instance of Harada-like syndrome in a chronic carrier of HBV. The findings suggest a potential immunologic link between persistent HBV infection and melanocyte-targeted autoimmunity.
