Outcomes of Intravitreal Bevacizumab in Choroidal Neovascularization in Vogt-Koyanagi-Harada Disease– A Prospective Study

Sakata, Viviane Mayumi; Morita, Celso; Lavezzo, Marcelo Mendes; Rodriguez, Ever Ernesto Caso; Abdallah, Smairah Frutuoso; Pimentel, Sérgio Luís Gianotti; Hirata, Carlos Eduardo; Yamamoto, Jiro

doi:10.1080/09273948.2019.1687731

Cited by 7 publications

(3 citation statements)

References 31 publications

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“…The visual outcome was unfortunately poor. In a very recent study, Sakata et al [ 18 ] evaluated the outcome of intravitreal bevacizumab administration in seven eyes of six patients with CNV and VKH syndrome. The CNV was juxtapapillary in two eyes, juxtafoveal in three eyes and subfoveal in two eyes.…”

Section: Discussionmentioning

confidence: 99%

Favorable clinical outcome with intravitreal aflibercept treatment in a case with bilateral choroidal neovascular membrane and quiescent Vogt-Koyanagi-Harada syndrome

İpek

Ayhan

Emre

et al. 2020

GMS Ophthalmology Cases; 10:Doc23

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Section: Discussionmentioning

confidence: 99%

Favorable clinical outcome with intravitreal aflibercept treatment in a case with bilateral choroidal neovascular membrane and quiescent Vogt-Koyanagi-Harada syndrome

İpek

Ayhan

Emre

et al. 2020

GMS Ophthalmology Cases; 10:Doc23

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“…During the 24-month follow-up period, the presence of ocular complications was recorded. CNV was diagnosed on FA and/or on OCT and was treated with an intravitreal bevacizumab injection and IMT increment (32). The primary outcomes were clinical and subclinical ares, BCVA and ffERG results at 24 months of follow-up.…”

Section: Multimodal Analysismentioning

confidence: 99%

Early azathioprine in acute Vogt-Koyanagi-Harada disease: a prospective 24-month follow-up study with multimodal imaging and electroretinogram

Lavezzo

Sakata

Souto

et al. 2022

Preprint

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Background: First-line immunosuppressive therapy (IMT) associated with high-dose corticosteroid (CS) has been proposed for the treatment of acute Vogt-Koyanagi-Harada disease (VKHD) to prevent chronicity and to prevent long-term CS side effects. However, there are very few studies that systematically evaluated visual and inflammatory outcomes in acute VKHD with early IMT. This study aimed to evaluate the outcome of high-dose corticosteroids with early addition of azathioprine (AZA) in patients with acute Vogt-Koyanagi-Harada disease (VKHD) followed for 24-month with systematic multimodal and electroretinogram exams.Methods: Prospective interventional study. Fifteen consecutive patients (30 eyes) with acute VKHD at a tertiary uveitis referral centre were followed for 24 months with systematic multimodal and full-field electroretinogram (ffERG) exams. Patients were treated with intravenous methylprednisolone followed by oral prednisone 1mg/kg/daily (CS) with slow taper and AZA introduction within 4 months. Anterior uveitis relapse, subclinical inflammation, best-corrected visual acuity (BCVA) and ffERG parameters were analyzed.Results: Fifteen patients (14 female) with a median age of 32 years were included. In the first month, 27 eyes (90%) had BCVA ≥20/40; at M24, all eyes (100%) had BCVA ≥20/25. Uveitis resolved in 28 eyes (93.3%) and became chronic recurrent in 2 eyes (6.7%); subclinical inflammation was still present in all eyes during the 24-month follow-up. ffERG parameters initially improved in all eyes; at M24, 23 eyes (76.7%) had subnormal results and 20 eyes (66.7%) had stable parameters. Eyes with very early treatment (n=12) had lower indocyanine green angiography score than eyes with early treatment (n=18) at M1 (p=0.012), but they had similar rates of recurrence, complications and ffERG parameters. Conclusion: Early AZA associated with high-dose corticosteroid was effective in improving BCVA and in controlling clinical inflammation. Isolate subclinical inflammation persisted in all eyes with no impact on ffERG in, at least, two thirds of these eyes, indicating that isolate subclinical inflammation may not be enough to indicate treatment increment.

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“…Desse modo, em casos de CNV associada à DVKH, deve-se instituir a imunossupressão sistêmica com a terapia local com agentes antiangiogênicos (194) .…”

Section: Complicaçõesunclassified

Análise multimodal e eletrofisiológica de pacientes na fase aguda da doença de Vogt-Koyanagi-Harada tratados prospectivamente com corticoterapia e imunossupressão precoce em um seguimento de 24 meses

Lavezzo¹

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Dedico esta tese a minha família! A meus pais Wagner e Otávia que me apresentaram à Universidade, desde criança, quando acompanhava seus projetos na Fazenda Experimental Lageado -UNESP, Campus de Botucatu. Obrigado por terem me proporcionado um de meus maiores bens: a educação! Obrigado pelo carinho, amor, ensinamentos, confiança, valores de respeito, dignidade e honestidade e pelo exemplo de seres humanos que são! Sem vocês, nada disso seria possível. Minha admiração eterna... A minha noiva, Caroline Midori, que se uniu a mim nesta empreitada quando o Doutorado já estava em andamento.Companheira de todas as horas, você me faz ser uma pessoa melhor! Obrigado pelo amor, carinho, compreensão, paciência, palavras de encorajamento e pelo apoio incondicional nos momentos difíceis. Você foi minha maior incentivadora para concluir este projeto e atingir meus objetivos! A meu irmão Rafael, obrigado pela sua amizade, carinho, estímulo e companheirismo, ao longo de todos estes anos! A minha cunhada Daniela, as minhas sobrinhas Sofia e Laura e à família Takigami, obrigado pelo desvelo, incentivo, momentos felizes e pelas palavras de apoio. AGRADECIMENTOSÀ Dra. Joyce Hisae Yamamoto Takiuti, exemplo de orientadora, sempre presente, dedicada, modesta, que prima pelo rigor técnico, conhecimento, competência, perfeccionismo, disciplina, ética e trabalho metódico. Sua busca incansável pelo academicismo merece total reconhecimento. Obrigado pela convivência e pelos ensinamentos inestimáveis, ao longo destes anos de Pós-Graduação.Ao Dr. Carlos Eduardo Hirata, pelas inúmeras contribuições e sugestões pertinentes e construtivas, feitas durante o desenvolvimento desta tese. À Dra. Maria Kiyoko Oyamada, pela paciência durante meu aprendizado das técnicas para realização dos exames de eletrorretinograma e também pelo constante auxílio na interpretação dos mesmos e na análise crítica dos trabalhos derivados desta tese.

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Outcomes of Intravitreal Bevacizumab in Choroidal Neovascularization in Vogt-Koyanagi-Harada Disease– A Prospective Study

Cited by 7 publications

References 31 publications

Favorable clinical outcome with intravitreal aflibercept treatment in a case with bilateral choroidal neovascular membrane and quiescent Vogt-Koyanagi-Harada syndrome

Favorable clinical outcome with intravitreal aflibercept treatment in a case with bilateral choroidal neovascular membrane and quiescent Vogt-Koyanagi-Harada syndrome

Early azathioprine in acute Vogt-Koyanagi-Harada disease: a prospective 24-month follow-up study with multimodal imaging and electroretinogram

Análise multimodal e eletrofisiológica de pacientes na fase aguda da doença de Vogt-Koyanagi-Harada tratados prospectivamente com corticoterapia e imunossupressão precoce em um seguimento de 24 meses

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