Clinical Outcomes of Patients with Vogt–Koyanagi–Harada Disease Over 12 Years at a Tertiary Center

Arévalo, J. Fernando; Lasave, Andrés F.; Gupta, Vishali; Kozák, Igor; Harbi, Mosa Barakat Al; Rushood, Abdulaziz Adel Al; Dhibi, Hassan Al

doi:10.3109/09273948.2015.1025984

Cited by 31 publications

(26 citation statements)

References 39 publications

(61 reference statements)

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“…Not surprisingly, a recent large case series of 154 patients from Saudi Arabia reported that the frequency of recurrences is lower in patients with acute VKH disease at presentation (37.6%) compared with patients with chronic recurrent VKH disease at presentation (79.2%) 23. However, our rate of recurrence appears to be lower thanto that report, most likely due to the higher doses of corticosteroids used initially.…”

Section: Discussioncontrasting

confidence: 63%

Clinical features and visual outcomes of 111 patients with new-onset acute Vogt-Koyanagi-Harada disease treated with pulse intravenous corticosteroids

et al. 2018

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Section: Discussioncontrasting

confidence: 63%

Clinical features and visual outcomes of 111 patients with new-onset acute Vogt-Koyanagi-Harada disease treated with pulse intravenous corticosteroids

et al. 2018

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“…Despite varying definitions of acute and chronic VKH in the literature, our results are consistent with those from two large retrospective studies which found that 70–80% of patients with acute VKH achieved a final visual acuity of 20/40 or better compared to only 40–56% of patients with chronic recurrent VKH. 5, 14 …”

Section: Discussionmentioning

confidence: 99%

“…9–14,17–19 Corticosteroids have long been accepted as the mainstay of treatment, with oral administration shown to be as effective as intravenous administration for initial therapy. 6 Most VKH studies analyze heterogeneous immunosuppressants as one group.…”

Section: Discussionmentioning

confidence: 99%

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Outcomes of Vogt-Koyanagi-Harada Disease: A Subanalysis From a Randomized Clinical Trial of Antimetabolite Therapies

Shen

Rathinam

Babu

et al. 2016

American Journal of Ophthalmology

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Purpose To report outcomes of Vogt-Koyanagi-Harada (VKH) disease from a clinical trial of antimetabolite therapies. Design Subanalysis from an observer-masked randomized clinical trial for non-infectious intermediate, posterior, and pan- uveitis. Methods Setting clinical practice at Aravind Eye Hospitals, India Patient Population Forty-three of 80 patients enrolled (54%) diagnosed with VKH. Intervention Patients were randomized to either 25mg oral methotrexate weekly or 1g mycophenolate mofetil twice daily, with a corticosteroid taper. Main outcome measures Primary outcome was corticosteroid-sparing control of inflammation at 5 and 6 months. Secondary outcomes included visual acuity, central subfield thickness, and adverse events. Patients were categorized as acute (diagnosis ≤3 months prior to enrollment) or chronic (diagnosis >3 months prior to enrollment). Results Twenty-seven patients were randomized to methotrexate and 16 to mycophenolate mofetil; 30 had acute VKH. The odds of achieving corticosteroid-sparing control of inflammation with methotrexate were 2.5 times (95% CI: 0.6, 9.8; P=0.20) the odds with mycophenolate mofetil, a difference which was not statistically significant. The average improvement in visual acuity was 12.5 Early Treatment Diabetic Retinopathy Study (ETDRS) letters. On average, visual acuity for patients with acute VKH improved by 14 more ETDRS letters than those with chronic VKH (P<0.001), but there was no difference in corticosteroid-sparing control of inflammation (P=0.99). All 26 eyes with a serous retinal detachment at baseline resolved, and 88% achieved corticosteroid-sparing control of inflammation. Conclusions The majority of patients treated with antimetabolites and corticosteroids were able to achieve corticosteroid-sparing control of inflammation by 6 months. Although patients with acute VKH gained more visual improvement than those with chronic VKH, this did not correspond with a higher rate of controlled inflammation.

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“…Cataract is the second most common complication of VKHD,157,158,161 with an incidence of up to 42% 2,34. Prolonged steroid treatment and recurrent ocular inflammation are the main risk factors for its development 1,30.…”

Section: Complications Associated With Vkhdmentioning

confidence: 99%

Vogt–Koyanagi–Harada syndrome – current perspectives

Baltmr¹,

Lightman²,

Tomkins-Netzer³

2016

OPTH

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Vogt–Koyanagi–Harada syndrome is a cause of noninfectious panuveitis, leading to significant vision loss in many patients. It is an autoimmune disease occurring in genetically susceptible individuals and clinically presents as bilateral panuveitis with serous retinal detachments and hyperemic, swollen optic discs, which are associated with neurological and auditory manifestations. Early diagnosis and prompt and adequate treatment with immunosuppressive agents (corticosteroids and other immunosuppressive drugs) may halt disease progression and prevent recurrences and vision loss. This review summarizes the current knowledge on the variable clinical aspects of this disease, highlighting diagnostic and treatment strategies.

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Clinical Outcomes of Patients with Vogt–Koyanagi–Harada Disease Over 12 Years at a Tertiary Center

Cited by 31 publications

References 39 publications

Clinical features and visual outcomes of 111 patients with new-onset acute Vogt-Koyanagi-Harada disease treated with pulse intravenous corticosteroids

Clinical features and visual outcomes of 111 patients with new-onset acute Vogt-Koyanagi-Harada disease treated with pulse intravenous corticosteroids

Outcomes of Vogt-Koyanagi-Harada Disease: A Subanalysis From a Randomized Clinical Trial of Antimetabolite Therapies

Vogt–Koyanagi–Harada syndrome – current perspectives

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Clinical Outcomes of Patients with Vogt–Koyanagi–Harada Disease Over 12 Years at a Tertiary Center

Cited by 31 publications

References 39 publications

Clinical features and visual outcomes of 111 patients with new-onset acute Vogt-Koyanagi-Harada disease treated with pulse intravenous corticosteroids

Clinical features and visual outcomes of 111 patients with new-onset acute Vogt-Koyanagi-Harada disease treated with pulse intravenous corticosteroids

Outcomes of Vogt-Koyanagi-Harada Disease: A Subanalysis From a Randomized Clinical Trial of Antimetabolite Therapies

Vogt&ndash;Koyanagi&ndash;Harada syndrome &ndash; current perspectives

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Vogt–Koyanagi–Harada syndrome – current perspectives