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Topical difluprednate for the treatment of Harada’s disease

Authors Onishi SM, Asahi MG, Chou C, Gallemore RP

Received 20 August 2014

Accepted for publication 16 October 2014

Published 21 January 2015 Volume 2015:9 Pages 157—167

DOI https://doi.org/10.2147/OPTH.S72955

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Editor who approved publication: Dr Scott Fraser

Spencer M Onishi, Masumi G Asahi, Calvin Chou, Ron P Gallemore

Retina Macula Institute, Torrance, CA, USA

Purpose: To describe the use of topical difluprednate for treatment of patients who presented with Harada’s disease.
Methods: Retrospective case series of patients managed with topical difluprednate alone at the onset of the diagnosis. The patients were followed with optical coherence tomography (OCT) and fluorescein angiography.
Results: In our three cases, complete resolution of the exudative detachments with improvement in visual acuity was achieved in each case. Central macular thickness was reduced by a mean of 365±222 µm. Initial loading dose was one drop every hour while awake, followed by a variable tapering regimen. Leakage on fluorescein angiography and exudative detachments on OCT both responded to treatment with difluprednate. In two of the three cases, the patients recovered vision to 20/20, and the third case recovered to 20/25. Steroid-induced glaucoma was observed and managed with one to two glaucoma drops as needed.
Conclusion: Difluprednate is effective for managing ocular manifestations of Harada’s disease. Further studies of this drug for the management of noninfectious posterior uveitis are warranted.

Keywords: serous retinal detachment, noninfectious posterior uveitis, steroid

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