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ArticleInternational ophthalmology2023

Outcomes of patients with acute Vogt-Koyanagi-Harada disease treated with intravenous corticosteroid pulse followed by the slow tapering of oral corticosteroid therapy.

Rui Fushitsu, Akihiro Ishibazawa, Masataka Murono, Reiko Kinouchi

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Article in International ophthalmology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

4 authors.

Rui FushitsuDepartment of Ophthalmology, Asahikawa Medical University, Midorigaoka-Higashi 2-1-1-1, Asahikawa, 078-8510, Japan.
Akihiro IshibazawaJapanese Red Cross Kitami Hospital, Hokkaido, Japan.
Masataka MuronoDepartment of Ophthalmology, Asahikawa Medical University, Midorigaoka-Higashi 2-1-1-1, Asahikawa, 078-8510, Japan.
Reiko KinouchiDepartment of Ophthalmology, Asahikawa Medical University, Midorigaoka-Higashi 2-1-1-1, Asahikawa, 078-8510, Japan. rkino@asahikawa-med.ac.jp.ORCID http://orcid.org/0000-0003-1344-1641

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo elucidate the intravenous corticosteroid pulse treatment outcomes of patients with acute Vogt-Koyanagi-Harada (VKH) disease and assess the differences between patients with no inflammation worsening and those with persistent or worsening inflammation. Potential factors responsible for eyes with low visual outcomes were also investigated.

methodsWe retrospectively reviewed the clinical records of patients with acute VKH disease who first visited us between 2009 and 2018 and were followed up for > 300 days. Clinical characteristics, treatments, and posttreatment conditions were assessed. Patients were classified into no inflammation worsening (acute-resolved [AR]) and inflammation worsening (chronic-recurrent [CR]) groups based on conditions after 6 months from disease onset.

resultsThis study included 60 eyes from 30 patients (mean age: 52.7 years). Patients were treated with methylprednisolone pulse followed by the slow tapering of oral prednisolone; 73% of patients developed AR and 27% CR, and the best-corrected visual acuity (BCVA) was ≥ 1.0 in 83% of eyes at 6 months following the introduction of treatment. Although the total prednisolone dose was higher in patients with CR disease, no significant difference was noted in the final BCVA. Among the patients, five eyes had a final BCVA of ≤ 0.5 due to anisometropic amblyopia, diabetic maculopathy, pre-existing macular hole, epiretinal membrane, and ellipsoid zone loss.

conclusionsPatients with acute VKH disease treated with corticosteroid pulse appear to demonstrate good visual outcomes, including patients with CR; the majority of eyes with low visual outcomes have pre-existing conditions that explain the low vision.

Indexed as

Uveomeningoencephalitic SyndromeAcute DiseaseAdrenal Cortex HormonesGlucocorticoidsHumansInflammationMethylprednisoloneMiddle AgedRetrospective StudiesAdrenal Cortex HormonesGlucocorticoidsMethylprednisoloneCorticosteroid pulse therapyRecurrenceVisual outcomeVogt–Koyanagi–Harada disease

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.