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Bernardo Ariel Schlaen, Juan Pablo Fernandez, Matias Portela, Mariana Ingolotti, Cristobal A Couto, Anahi Lupinacci, Mario Joaquin Saravia; Medical treatment in patients with Vogt Koyanagi Harada Syndrome in a tertiary university center in Argentina. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3117. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To describe medical treatment received by patients with diagnosis of Vogt Koyanagi Harada Syndrome in a tertiary university center.
Patients with diagnosis of Vogt Koyanagi Harada Syndrome who were seen at Hospital Universitario Austral between June 2009 and October 2014 were included. Data recorded included, age, sex, category of diagnosis (complete, incomplete or probable), treatment regime (early with high dose of corticosteroids, within 15 days of symptoms presentation; late with high dose of corticosteroid, after 15 to 30 days of presentation; other treatment regimen), regional treatment (subtenon triamcinolone acetonide, intravitreal triamcinolone acetonide, intravitreal metotrexate), immunosuppressive therapy, and complications.<br /> Statistical analysis was carried out using excel 2012. Chi square was used as appropriate.
Thirty five patients (28 females, 7 males) with diagnosis of Vogt Koyanagi Harada Syndrome were included. Average age was 36 ±14.38 years. Incomplete Vogt Koyanagi Harada Syndrome was seen in 18 patients, complete in 8 cases, and probable in 9 patients. High dose oral corticosteroids was administered to 33 patients (early high: 12 patients; late high: 18 patients; other: 5 patients). Subtenon triamcinolone acetonide was performed in 8 patients, intravitreal triamcinolone acetonide in 2 patients, and intravitreal methotrexate in 2 patients. Immunosuppressive treatment was administered to 24 patients (68.57%). Among 12 patients who underwent early high regime 5 patients needed immunosuppressive treatment, while 17 of 18 patients with late high treatment required immunosuppressive treatment (Chi square, P < 0.01). Seven patients (20%) underwent cataract surgery, 5 patients were treated for ocular hypertension (14%), 2 patients had epiretinal membrane, 2 patients had macular edema, and 1 patient had choroidal neovascularization. None of the 12 patients with early high dose of corticosteroid treatment developed complications, 9 out of 18 patients with late high dose of corticosteroid regime developed complications, and 4 out of 5 patients with other regime developed complications (Chi square, P <0.01).
Treatment of patients with Vogt Koyanagi Harada Syndrome within 15 days of symptoms presentation with high dose corticosteroid regime reduces the need of immunosuppressive treatment and the number of complications.
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