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

Nakayama, Makiko; Keino, Hiroshi; Watanabe, Takayo; Okada, Annabelle A.

doi:10.1136/bjophthalmol-2017-311691

Cited by 58 publications

(57 citation statements)

References 30 publications

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“…With optimal management including early combined steroidal and first-line nonsteroidal immunosuppression, SGF should not be considered part of the natural course of the disease, but rather the result of insufficient treatment that failed to stop subclinical choroidal inflammation [45]. In contrast to many reports, a recent report stated that corticosteroid therapy in initial-onset disease was sufficient to achieve a satisfactory outcome with nonsteroidal immunosuppression necessary in only 15.3% of cases [46]. No information was given, however, on the rate of clinical chronic evolution, nor on occult chronic evolution as ICGA was not performed.…”

Section: Association Of Steroidal and Non-steroidal Immunosuppressionmentioning

confidence: 76%

Catching the therapeutic window of opportunity in early initial-onset Vogt–Koyanagi–Harada uveitis can cure the disease

et al. 2018

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Section: Association Of Steroidal and Non-steroidal Immunosuppressionmentioning

confidence: 76%

Catching the therapeutic window of opportunity in early initial-onset Vogt–Koyanagi–Harada uveitis can cure the disease

et al. 2018

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“…The duration from first visit to steroid administration was very short. This was taken as a likely reason for the low recurrence rate for VKH compared with other reports without the use of immunosuppression therapy [7].…”

Section: Discussionmentioning

confidence: 93%

“…A Korean study found that the HLA DRB1*0405 allele conferred an increased relative risk of developing VKH compared with the general population, and that the HLA DRB1*0405-DQA1*0302-DQB1*0401 haplotype was associated with poorer visual prognosis [6]. On the other hand, despite systemic corticosteroid approach, VKH patients often prove refractory to systemic corticosteroid therapy with long follow-up [7,8]. For predicting prognosis and refractoriness to treatment, the focus in recent years has transitioned from the identification of HLA genes associated with increased risk of VKH to the identification of alternate genes [9,10].…”

Section: Introductionmentioning

confidence: 99%

Correlation between visual acuity and human leukocyte antigen (HLA)-DRB1*04 in patients with Vogt-Koyanagi-Harada disease

Misawa

Tagami

Kohno

et al. 2019

Preprint

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Background: The common presence of human leukocyte antigen (HLA)-DRB1*04 in Vogt-Koyanagi-Harada (VKH) disease is well known. The aim of this study was to investigate the relationship between visual prognosis and HLA-DRB1*04 alleles during systemic corticosteroid therapy in patients with VKH disease. Methods: This retrospective case series included 57 eyes from 29 consecutive patients with treatment-naïve VKH disease who received systemic corticosteroid therapy. Visual acuity, sex, refractive error, central retinal thickness (CRT), central choroidal thickness (CCT), and duration from onset to treatment were measured at initial and final visits. Mean values of parameters were compared with each visit. Genotyping was performed by polymerase chain reaction amplification with sequence-specific primer. Results: Linear regression showed significant differences in logMAR best-corrected visual acuity between the three groups of homozygotes, heterozygotes, and normal subjects at baseline ( p <0.01), at three months after treatment ( p <0.01).There was no significant differences at six months after treatment ( p =0.257). No significant differences were detected between the three groups in age, sex, refractive error, CRT, CCT, or duration from onset to treatment. Conclusion: Alleles of HLA-DRB1*04 might affect visual prognosis and be related to early response after initiation of treatment in VKH disease.

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Section: Introductionmentioning

confidence: 99%

Correlation between visual acuity and human leukocyte antigen (HLA)-DRB1*04 in patients with Vogt-Koyanagi-Harada disease

Misawa

Tagami

Kohno

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: The common presence of human leukocyte antigen (HLA)-DRB104 in Vogt-Koyanagi-Harada (VKH) disease is well known. The aim of this study was to investigate the relationship between visual prognosis and HLA-DRB104 alleles during systemic corticosteroid therapy in patients with VKH disease. Methods: This retrospective case series included 57 eyes from 29 consecutive patients with treatment-naïve VKH disease who received systemic corticosteroid therapy. Visual acuity, sex, refractive error, central retinal thickness (CRT), central choroidal thickness (CCT),and duration from onset to treatment were measured at initial and final visits. Mean values of parameters were compared with each visit. Genotyping was performed by polymerase chain reaction amplification with sequence-specific primer. Results: Linear regression showed significant differences in logMAR best-corrected visual acuity between the three groups of homozygotes, heterozygotes, and normal subjects at baseline ( p <0.01), at three months after treatment ( p <0.01).There was no significant differences at six months after treatment ( p =0.257). No significant differences were detected between the three groups in age, sex, refractive error, CRT, CCT, or duration from onset to treatment. Conclusion: Alleles of HLA-DRB1*04 might affect visual prognosis and be related to early response after initiation of treatment in VKH disease.

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

Abstract: An aggressive corticosteroid treatment strategy in a large number of patients with new-onset acute VKH disease, with transitioning to cyclosporine in selected cases, resulted in excellent visual outcomes and low rates of recurrence.

Cited by 58 publications

References 30 publications

Catching the therapeutic window of opportunity in early initial-onset Vogt–Koyanagi–Harada uveitis can cure the disease

Catching the therapeutic window of opportunity in early initial-onset Vogt–Koyanagi–Harada uveitis can cure the disease

Correlation between visual acuity and human leukocyte antigen (HLA)-DRB1*04 in patients with Vogt-Koyanagi-Harada disease

Correlation between visual acuity and human leukocyte antigen (HLA)-DRB1*04 in patients with Vogt-Koyanagi-Harada disease

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