December 2002
Volume 43, Issue 13
Free
ARVO Annual Meeting Abstract  |   December 2002
Vogt-koyanagi-harada Syndrome: Glucocorticoid Therapy and Visual Prognosis
Author Affiliations & Notes
  • T-S Hu
    Ophthalmology Peking Union Med Coll Hospital Beijing China
  • MF Zhang
    Beijing China
  • Q Liu
    Beijing China
  • HY Min
    Beijing China
  • Footnotes
    Commercial Relationships   T. Hu, None; M.F. Zhang , None; Q. Liu , None; H.Y. Min , None.
Investigative Ophthalmology & Visual Science December 2002, Vol.43, 4273. doi:
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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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Abstract

Abstract: : 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.  

Keywords: 377 corticosteroids • 327 autoimmune disease • 357 clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials 
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