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T. Kaburaki, S. Fujimura, Y. Fujino, A. Yoshida, J. Numaga, M. Tubota, H. Kawashima; Periocular Injections of Triamcinolone for Posterior Recurrence of Vogt–Koyanagi–Harada Disease . Invest. Ophthalmol. Vis. Sci. 2006;47(13):2427.
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© ARVO (1962-2015); The Authors (2016-present)
For posterior recurrence of Vogt–Koyanagi–Harada disease (VKHD), to increase the dosage of systemic corticosteroid or additional use of immunosuppressive agents is usually the choice of treatment conventionally. Now, we report three cases where posterior recurrences of VKHD were successfully treated by periocular triamcinolone injections without increasing or additional use of systemic immunosuppressive drugs.
Cases are 53 year old (y.o.) woman, 65 y.o. man, and 35 y.o. man. All cases initially received corticosteroid pulse–therapy against VKHD that was followed with 40mg of oral prednisolone. All cases suffered from the recurrence of posterior uveitis type during tapering or after withdrawal of oral corticosteroids. The recurrence of posterior uveitis was diagnosed by the findings of fluorescein angiography (papillitis, multifocal leakage spots on retinal pigment epithelium) and optical coherence tomography (serous retinal detachment near the optic disc). The recurrence occurred on 82, 85, and 69 days after the corticosteroid pulse therapy, and the dosage of oral prednisolone at the time of recurrence was 15, 0, and 10mg/day, respectively. We performed 40mg of periocular triamcinolone injections without increasing dose of oral corticosteroid or additional use of immunosuppressants.
Serous retinal detachment disappeared in all cases within one or two weeks after periocular triamcinolone injections. No additional recurrences occurred in all cases, and oral prednisolone was gradually tapered in all cases without increasing the dosage.
Periocular triamcinolone injections were effective for posterior recurrence in VKHD. This method may have a benefit of shortening the duration of oral corticosteroid usage for VKHD patients especially who suffer from posterior recurrences.
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