Vogt–Koyanagi–Harada disease: diagnosis and treatments update

Bordaberry, Marcela F

doi:10.1097/icu.0b013e32833eb78c

Cited by 46 publications

(39 citation statements)

References 39 publications

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“…The use of intravenous pulse therapy as an initial treatment is still controversial, and has not yet proven to result in better visual acuity afterwards. [3,10,11,13] In our case series patients seemed to reach complete remission more often (80% vs. 42%) when treated with iv steroids initially.…”

Section: Discussionmentioning

confidence: 90%

“…Intravitreal injections can be applied to treat intra-or subretinal fluid. [10,11] Second or third line immunomodulating therapy (e.g. methotrexate, azathioprine, cyclosporine, rituximab, adalimumab) is given in case of corticosteroid resistance or side effects.…”

Section: Introductionmentioning

confidence: 99%

“…methotrexate, azathioprine, cyclosporine, rituximab, adalimumab) is given in case of corticosteroid resistance or side effects. [1][2][3][4][10][11][12][13][14][15] Ocular complications linked to both disease activity and treatment may lead to permanent visual loss after extinction of the uveitic phase. [3,10] The visual prognosis of VKHS varies and depends mainly on early diagnosis and rapid appropriate treatment.…”

Section: Introductionmentioning

confidence: 99%

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Vogt-Koyanagi-Harada syndrome: Experience in a Belgian university hospital and review of the literature

Sels

Calster

Vanderschueren

et al. 2017

CRIM

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Introduction: The Vogt-Koyanagi-Harada syndrome (VKHS) is rare in Europe. Bilateral panuveitis is the defining characteristic, but the disease can affect other tissues containing melanin, such as the inner ear, the meninges, and the skin. Therefore, patients may present not only to ophthalmologists, but also to internists, dermatologists, ENT-physicians and neurologists. Early and aggressive immunosuppressive treatment is necessary in order to prevent permanent visual loss or systemic complications. Objective: We retrospectively studied 12 patients diagnosed and treated in a specialized uveitis clinic in Leuven (Belgium) between 2005 and 2013, and we compared our data with literature. Results:The most common extra-ocular manifestations were neurological, with headache (100%) and lymphocytic meningitis (75%) as main findings. Tinnitus was present in 50%, and vertigo in 42%. Vitiligo was the most frequent dermatological manifestation and present in 42%. Uveitis recurred in 67% of patients with 1 to 4 relapses per patient and a median time to recurrence of 6 months (range 1-11). Normal visual acuity was seen in 75% of patients at the end of follow-up (5 to 60 months), but 3 patients had at least some degree of permanent visual impairment in at least one eye. Conclusion: VKHS is a rare, multisystem disorder, characterized by bilateral uveitis and variable neurologic, auditory and skin symptoms. A lumbar puncture increases the diagnostic yield. A fast diagnosis allows timely initiation of adequate therapy, and If treated correctly, VKHS has a favorable prognosis. It is unclear if initial intravenous therapy improves frequency and time to remission.

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Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Vogt-Koyanagi-Harada syndrome: Experience in a Belgian university hospital and review of the literature

Sels

Calster

Vanderschueren

et al. 2017

CRIM

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“…1 The OCT (optical coherence tomography) scan showed serous detachment of the macula in both eyes along with a small pigment epithelial detachment (PED) in the right eye corresponding to the area of smokestack leak seen on FA and also showed typical folds of RPE (retinal pigment epithelium)/Bruch's membrane seen in VKH in both eyes (Figure 2c, d). 4 She was started on oral steroid therapy (tablet prednisolone 60 mg (1 g/kg) and an immunosuppressant (tablet azathioprine 50 mg twice a day).…”

mentioning

confidence: 99%

“…6 The treatment for CSCR and that of VKH is completely different, with steroids, being the mainstay of therapy in VKH but being contraindicated in CSCR. 1 We treated our case with systemic steroids and immunosuppressants. In our patient, the addition of an immunosuppressant (as a steroidsparing agent) also helped to rapidly taper systemic steroids.…”

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confidence: 99%