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Ayaka Takeda, Naka Shiratori, Satoko Yui, Junko Hori; Clinical course and treatment of prolonged cases in Vogt-Koyanagi-Harada disease.. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3504.
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© ARVO (1962-2015); The Authors (2016-present)
To characterize the clinical course and treatment of prolonged cases in Vogt-Koyanagi-Harada disease(VKH).
This retrospective study involved 42 patients of VKH who visited Nippon Medical School Hospital from January 2008 to January 2018. The subjects included 11 prolonged cases (6 male and 5 female). The mean age of these patients at uveitis presentation was 53.0±11.6 years. Patients were diagnosed with VKH disease using revised criteria proposed by the International Nomenclature Committee in 2001. They were classified into three categories: complete VKH was 1 case, incomplete VKH was 10 cases, and probable VKH was none. Prolonged cases were defined as persistent intraocular inflammation over 6 months after steroid therapy. Initial treatments and treatments needed for clinical remission for these patients were assessed.
Mean observation period for 11 prolonged cases was 42±34months. Among 11 cases, 5 were fresh cases who received steroid pulse therapy in initial therapy followed by oral steroid therapy. The other 6 cases among 11 cases visited our hospital after previous treatments at other hospital. Previous treatments for these 6 cases include steroid pulse therapy(n=2), oral steroid therapy(n=1), untreated (n=1), and unknown (n=1). Treatments needed for clinical remission for these 11 prolonged cases include oral steroid therapy( n=3), oral steroid and cyclosporine (n=6), and adalimumab and cyclosporine(n=1). One case needed oral steroid and intravitreous ranibizumab to suppress inflammatory choroidal neovascularization (CNV) (n=1).
Combination of steroid and cyclosporine or adalimumab were effective to induce clinical remission for prolonged VKH cases. Intravitreous ranibizumab suppressed inflammatory CNV in prolonged VKH.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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