Purchase this article with an account.
Na mi Kim, Jin Hwan Ahn, Jong Ho Park, Jun Mo Park, Ji Eun E. Lee, Boo Sup Oum; Long-term Outcomes Of High-dose Intravenous Steroid Pulse Therapy For Vogt-Koyanagi-Harada Disease. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2760.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To analyze outcomes observed from follow ups over 3+ years, after high-dose intravenous steroid therapy for Vogt-Koyanagi-Harada (VKH) disease.
We retrospectively reviewed the medical records (initial and final visual acuities, complications, number of recurrences, and whether immunosuppressive agents were discontinued or not) of patients whose VKH disease had been treated with high-dose intravenous steroids. After administering high-dose steroid pulse therapy (intravenously injecting 1,000 mg/day methylprednisolone for 4 d on average), an orally taken steroid was prescribed, the dosages of which were tapered off over several months.
A total of 14 patients were included in the study. Initial visual acuity was the mean of logMAR 0.70 ± 0.57. The patients were followed up for 52.1 ± 20.6 months. Final visual acuity improved as the mean of logMAR 0.04 ± 0.05. As for other manifestations, alopecia manifested in one patient and vitiligo in another, and posterior depigmentation developed in 21 eyes. Cataract extraction was performed in seven eyes, and no glaucoma surgery was needed. Six (42.9%) patients had a chronic disease course. Inflammation relapsed as exudative retinal detachment in two patients, and anterior inflammation relapsed in four patients. In the patients with chronic courses, visual acuity was the mean of logMAR 0.06 ± 0.05, which was significantly worse than that in the patients with an acute course. Systemic steroids and/or immunosupressive agents were discontinued in 12 patients (85.7%).
In most of the patient outcomes, observed in follow-ups extending beyond 3 years after high-dose intravenous steroid therapy for VKH, good prognoses were indicated for visual acuity, and high rates of remission were obtained. Relatively poor prognoses of visual acuity were related to chronic VKH cases.
This PDF is available to Subscribers Only