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Carlos Javier Fernandez, Juan Carlos Almodovar, Rosa A Lozada, Carmen Santos, Armando Oliver; Therapeutic Outcomes of a Standardized Protocol Using Immunosuppressive Agents Early Since The Diagnosis of Vogt-Koyanagi-Harada Syndrome.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3107.
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The use of immunosuppressive therapy, along with systemic corticosteroids, improves the clinical outcomes of patients with Vogt-Koyanagi-Harada Syndrome. The most efficient means to administer immunosuppressive therapy to these patients remains unestablished. We evaluated a retrospective series of patients treated with a standardized protocol in which immunosuppressive medications where started within the first month after the diagnosis of Vogt-Koyanagi-Harada Syndrome.
We performed a retrospective chart review of all the patients treated with a standardized treatment protocol (see Fig. 1) at a tertiary ophthalmology referral center. We analyzed data from demographics, clinical presentation features, visual acuity outcomes and steroid sparing success.
Sixteen eyes of eight patients were treated using the protocol. Eighty-one and fifty percent of eyes had visual acuity worse than 20/50 and 20/200, respectively upon presentation. Eighty-six percent of patients completed one year of follow-up; after which, 100% percent of eyes had a visual acuity of 20/200 or better while 67% of eyes had a visual acuity of 20/30 or better. At one year, 100% of patients had achieved steroid sparing success to a dose 10mgs of prednisone or less and 43% had achieved a dose of 5mgs of prednisone or less. The most common immunosuppressive agent were azathioprine and mofetil mycophenolate; which were used in 63% of patients.
A standardized treatment protocol in which steroid sparing agents are introduced for the treatment of Vogt-Koyanagi-Harada Syndrome since early in the onset of the condition appears to be effective in providing patients with good visual outcomes and helps them achieve steroid sparing success in the vast majority of cases.
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