Purchase this article with an account.
S. Sukavatcharintr, M. Evans, J. Tsai, L. LaBree, N.A. Rao; Vogt–Koyanagi–Harada Syndrome: Response to Systemic Corticosteroids . Invest. Ophthalmol. Vis. Sci. 2006;47(13):2428.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To study the long term clinical outcome of patients treated with systemic corticosteroids for the management of Vogt–Koyanagi–Harada (VKH)disease.
Medical records of 67 patients with VKH disease seen at Doheny Eye Institute were reviewed for demographic features, visual acuity, ocular findings (including grading of intraocular inflammation), ocular complications (including cataract, ocular hypertension, glaucoma, subretinal neovascularization, and subretinal fibrosis) and for treatment with systemic corticosteroids 1–1.5 mg/kg and/or other immunosuppressive agents. The patients were divided in 2 groups; acute (22 patients) and chronic (45 patients) and the above clinical parameters were evaluated at 2–4 weeks, 5–12 weeks and 13 weeks or more. The data was analyzed by chi–square test.
All 22 patients in the acute group received systemic corticosteroids only; in the chronic group, 27 patients received systemic corticosteroids and the remaining 18 received corticosteroids plus other immunosuppressive agents. Of the 22 patients in the acute group, the right eye showed improvement in visual acuity (2 lines or better) in 71% during 2–4 weeks; 93% during 5–12 weeks, and 82% after 13 weeks. Whereas in the left eye, 50% had improvement during 2–4 weeks, 73% improved during 5–12 weeks and 100% after 13 weeks. Of the chronic group, right eye showed improvement in visual acuity in 45%, 41% and 22% during 2–4 weeks, 5–12 weeks, and after 13 weeks respectively. The left eye revealed improved visual acuity in 27%, 35%, and 26% during 2–4 weeks, 5–12 weeks, and after 13 weeks respectively.
This study suggests that oral corticosteroids are effective in improving visual acuity in 82–100% of the eyes in patients presenting with acute disease. In contrast, only 22 to 26% (P=0.0003) of the eyes of patients with chronic disease showed improvement. Patients in the chronic group also experienced severe complications. In the acute group, 45% developed cataract and/or ocular hypertension. In the chronic group, 87% developed one or more complications (cataract, glaucoma, subretinal neovascularization, subretinal fibrosis). These findings suggest that corticosteroids and other immunosuppressive agent are required in patients presenting with chronic disease.
This PDF is available to Subscribers Only