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On-Tat Lee, Philip Storey, Jeffrey Tan, Hassan A Aziz, Jiun Do, Brandon James Wong, Anna Ter-Zakarian, Damien C Rodger, Narsing A Rao; Visual outcome with immunomodulatory intervention in Chronic Vogt-Koyanagi-Harada Disease. Invest. Ophthalmol. Vis. Sci. 2017;58(8):507.
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© ARVO (1962-2015); The Authors (2016-present)
To report the clinical findings and outcomes of patients with chronic Vogt-Koyanagi-Harada (VKH) disease.
In a consecutive case series, the ocular history, medication use, and clinical findings of 36 patients diagnosed with chronic VKH at the Los Angeles County + USC Medical Center who were seen between May 1, 2014 and April 1, 2016 were reviewed.
Of the 36 patients, 69.4% were female and 97.2% were Hispanic. The mean age was 36.0 years (range 15-58) and average follow-up was 3.8 years. Over the course of treatment, 100% of patients had bilateral involvement. At final follow-up, persistently active disease was seen in 25.0% of eyes. At first presentation, visual acuity was 20/100 or better in 50.0% of eyes, which improved to 69.4% of eyes at final follow up (p=0.042). The majority of patients required immunomodulatory therapy (IMT) consisting of azathioprine, cyclosporine, infliximab, methotrexate or mycophenolate mofetil: 80.6% of patients received both oral steroids and IMT, 13.9% received oral steroids alone, and 5.6% of patients received only topical treatment. At final follow-up, ocular manifestations included: retinal pigment epithelium clumping (61.1%), fundus depigmentation (55.6%), nummular scars (45.8%), chronic anterior uveitis (12.5%), chronic posterior uveitis (12.5%), and serous retinal detachment (4.2%). Additional findings included: cataracts/intraocular lens implantations (55.6), glaucoma (47.2%), subretinal fibrosis (12.5%), and choroidal neovascular membranes in (5.6%).
In the current study, the majority of patient with chronic VKH were of Hispanic ethnicity with a female predominance. Despite chronic complications, the majority of patients retained visual acuity of 20/100 or better with a combination of corticosteroids and steroid sparing agents.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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