Correlation between peripapillary atrophy and corticosteroid therapy in patients with Vogt–Koyanagi–Harada disease

Abstract

Aims To determine the correlation between systemic corticosteroid therapy and the occurrence and size of peripapillary atrophy (PPA) in patients with Vogt-Koyanagi-Harada (VKH) disease. Methods All patients with VKH disease were retrospectively reviewed for their corticosteroid regimen. The extent of the PPA, if present, was measured using digitized imaging software, by two masked observers. Eyes with myopia greater than 6 dioptres or glaucoma were excluded. The patients were classified into three groups: early high (EH), late high (LH), and low dose (LD), according to the dose and timing of corticosteroids received during the acute phase of the disease. Results There were 40 eyes in the EH group, 25 eyes in the LH group, and 23 eyes in the LD group. Multivariate analysis showed that corticosteroid therapy was the main determinant of PPA occurrence. All the eyes in the LD group had PPA and eyes in the LH groups were 4.02 times (95% confidence interval 1.24-13.07) more likely to develop PPA than those in the EH group. The LD group also had larger PPA to disc ratios than the EH group. (Mean of 2.83 vs 0.19, Po0.001) Conclusion The development and extent of PPA in patients with VKH disease appear to be dependent on the dose and timing of systemic corticosteroids.

Prompt therapy reduces the duration of systemic corticosteroids in Vogt-Koyanagi-Harada disease

“…We took up the total period of receiving systemic corticosteroids as a primary endpoint in this study. According to another study, patients received more than 1 mg/kg (body weight)/day of prednisolone starting within 2 weeks of the acute phase of VKH disease were less likely to have recurrences and had less frequent episodes than those starting later than 2 weeks among Chinese people [2]. Though their initial dose of corticosteroid was different from the present study, our present results corresponded to previous studies from other ethnic groups.…”

Enhanced Depth Imaging Optical Coherence Tomography of the Choroid in Vogt–koyanagi–harada Disease

“…16 Finally, it has also been shown that the development of PPA is associated with delayed or inadequate immunosuppressive therapy. 17 Taken together, we speculate that choroidal thickness as measured by EDI-OCT in the early stage of acute VKH disease may aid in predicting visual outcome.…”

Choroidal Thickness in Convalescent Vogt–koyanagi–harada Disease

“…Earlier, Jap et al 21 showed that the development and extent of PPA were depended on the dose and timing of the systemic corticosteroid therapy implying that the PPA formation is the consequence of the intraocular inflammation. Earlier, Jap et al 21 showed that the development and extent of PPA were depended on the dose and timing of the systemic corticosteroid therapy implying that the PPA formation is the consequence of the intraocular inflammation.…”