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T-S Hu, MF Zhang, Q Liu, HY Min; Vogt-koyanagi-harada Syndrome: Glucocorticoid Therapy and Visual Prognosis . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4273.
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Purpose: Vogt-Koyanagi-Harada Syndrome (VKH) is an autoimmune disease with melanocyte as target cell. This study was to evaluate the efficacy of glucocorticoid therapy in patients with VKH Syndrome. Methods: One hundred and thirty six patients with VKH were treated with two regimens of oral prednisone. Regimen 1. Fifty-one patients with VKH were treated at the uveitic stage with prednisone, the initial dose was 2 mg/kg/d taping gradually and shifting to alternate-day treatment. The duration of treatment was approxiamately 8 months. Regimen 2. Eighty-five patients with VKH were referrals who were treated elsewhere with systemic glucocorticoid more than 2 months with total dose equivalent to prednisone more than 2000mg. Systemic and ocular complications were found in some of these patients. The hypothalamus-pituitary-adrenal axis was markedly inhibited as indicated by decrease in urinary free cortisol (UFC). These patients were treated with oral prednisone for 6-10 months based on the patients' individual ocular situations. The visual results, frequency of recurrence of uveitis and incidence of ocular complications were compared between the two groups. Results: The visual acuity, recurrence and ocular complications are shown in the following table. All the differences are highly significant (P<0.001)(Arabic numerals in the parenthesis in the table are number of eyes). The UFC level in the patients treated with Regimen 2 was increased from 5.35.8 µg/24h to 21.97.2 µg/24h (P<0.001). Conclusions: These results indicate that both regimens were feasible for treating patients with VKH. However, regimen 1 was far better than regimen 2 with respect to visual prognosis, frequency of recurrence of uveitis as well as incidence of ocular complications. View OriginalDownload SlideView OriginalDownload Slide
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