Clinical spectrum and management options in Vogt–Koyanagi–Harada disease
Authors Lodhi SA, Reddy JM, Peram V
Received 17 February 2017
Accepted for publication 14 June 2017
Published 7 August 2017 Volume 2017:11 Pages 1399—1406
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 3
Editor who approved publication: Dr Scott Fraser
Sikander AK Lodhi, JM Lokabhi Reddy, Venkataratnam Peram
Department of Ophthalmology, Osmania Medical College/Sarojini Devi Eye Hospital, Hyderabad, Telangana, India
Purpose: The aim of this study was to describe the clinical features, treatment options, and visual outcome of Vogt–Koyanagi–Harada (VKH) disease patients over a 9-year period.
Method: A retrospective chart analysis of 32 patients with VKH, from January 2007 to December 2015, at a tertiary care government medical college eye hospital in South India.
Results: A total of 32 patients were diagnosed with VKH. The mean age at diagnosis was 32.03±8.8 years. There were 24 patients (42 eyes) with acute VKH and eight patients (16 eyes) with recurrent/chronic VKH. The mean baseline best-corrected visual acuity on presentation in the acute VKH group was 5/60 (1.114±0.565) and at last follow-up it was 6/9 (0.225±0.157). Intravenous methyl prednisolone (IVMP) was administered for 3 days to all patients with acute and recurrent VKH, followed by posterior subtenon triamcinolone (40 mg/mL) and oral azathioprine.
Conclusion: VKH-related uveitis is more common in the female gender in this South Indian population. Posterior uveitis is the most common initial manifestation. Initial aggressive treatment with IVMP, peribulbar long-acting corticosteroids, and immunosuppressives, avoiding side effects of systemic steroids, gives a good visual outcome without recurrences. Cases of unilateral VKH, seen in six patients, are the initial manifestations in the natural course of the disease, which if managed aggressively at the acute stage prevents recurrence in the other eye.
Keywords: Vogt–Koyanagi–Harada disease, female, posterior uveitis, retinal detachment, triamcinolone, azathioprine
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