Risk factors for secondary Glaucoma in patients with Vogt-Koyanagi-Harada disease

Alvarez-Guzman, Carlos; Hartleben-Matkin, Curt; Ruiz-Lozano, Raúl E.; Rodríguez-García, Alejandro; Quiroga-Garza, Manuel E.; Valdez-García, Jorge E.

doi:10.1186/s12348-022-00300-7

Cited by 4 publications

(2 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We found that disease-related adverse events or complications (e.g. ocular hypertension, secondary glaucoma, iris synechiae), which are usually seen in late-phase disease 37 , occurred more frequently in the adalimumab group than in the cyclosporine group. These complication outcomes were in line with the observed visual prognosis.…”

Section: Discussionmentioning

confidence: 84%

A randomized non-inferiority trial of therapeutic strategy with immunosuppressants versus biologics for Vogt-Koyanagi-Harada disease

Zhong

Dai

et al. 2023

Nat Commun

View full text Add to dashboard Cite

Biologics are increasingly used to treat Vogt-Koyanagi-Harada disease, but head-to-head comparisons with conventional immunosuppressants are lacking. Here in this randomized trial (Chinese Clinical Trial Registry, ChiCTR2100043061), we assigned 110 patients (27 early-phase and 83 late-phase) to cyclosporine-based immunosuppressant strategy (N = 56) or adalimumab-based biologic strategy (N = 54), each combined with a modified corticosteroid regimen. The primary outcome is change from baseline in best-corrected visual acuity at week 26. The margin of non-inferiority for cyclosporine is −7 letters. The primary outcome is 11.2 letters (95% CI, 7.5 to 14.9) in the cyclosporine group and 6.3 letters (95% CI, 3.1 to 9.6) in the adalimumab group (difference, 4.9; 95% CI, 0.2 to 9.5; P < 0.001 for non-inferiority). The between-group difference is −0.8 letters (95% CI, −6.1 to 4.5) in early-phase disease and 5.7 letters (95% CI, 0.2 to 11.2) in late-phase. Serious adverse events are reported less frequently in the cyclosporine group than in the adalimumab group (0.70 vs. 1.21 events per patient-year). Here, we report that combined with a non-standard corticosteroid regimen, cyclosporine-based immunosuppressant strategy is non-inferior to adalimumab-based biologic strategy by 26 weeks for visual improvement in a cohort of patients with Vogt-Koyanagi-Harada disease, 75% of whom have a late-phase disease.

show abstract

Section: Discussionmentioning

confidence: 84%

A randomized non-inferiority trial of therapeutic strategy with immunosuppressants versus biologics for Vogt-Koyanagi-Harada disease

Zhong

Dai

et al. 2023

Nat Commun

View full text Add to dashboard Cite

show abstract

“…Recurrent VKH is more prominent in anterior segments, with more prevalent mutton-fat keratic precipitates, cells and flare in the anterior chamber, posterior synechiae, and iris nodules, and less prominent SRD [5]. Recurrent anterior uveitis is associated with higher complication rates of cataracts, glaucoma, and neovascular membranes, for which stronger and prolonged systemic immunosuppression and additional treatments are needed [5][6][7][8]. More prolonged and stronger immunosuppression at the time of the initial acute-onset VKH disease may help to reduce the rate of chronic recurrent evolution of the disease when risk factors for recurrent anterior uveitis are considered.…”

mentioning

confidence: 99%

Incidence and Risk Factors of Recurrent Anterior Uveitis in Initial Acute-Onset Vogt-Koyanagi-Harada Disease

Lim¹,

Byon²,

Kim³

et al. 2023

Korean J Ophthalmol

View full text Add to dashboard Cite

Purpose: We report the estimated incidence of, and risk factors for, recurrent anterior uveitis in patients with initial acute-onset Vogt-Koyanagi-Harada (VKH) disease using survival analyses.Methods: Patients who were diagnosed with initial acute-onset VKH disease during 2003–2022 at two university hospitals were included. Recurrent anterior uveitis was defined as the first occurrence of the granulomatous anterior uveitis with anterior chamber cells and flare of 2+ or more by the Standardization of Uveitis Nomenclature (SUN) Working Group grading scheme, after the disappearance of conspicuous uveitis and serous retinal detachment for at least 3 months, regardless of systemic or local treatment. The univariate log-rank test and multivariate Cox regression analyses were performed, including patients’ demographic characteristics, underlying diseases, presence of prodromal symptoms, duration of visual symptoms, visual acuity, slit-lamp and fundus findings, and height of serous retinal detachment. The treatment method and response to treatment were also included.Results: The estimated incidence was 39.3% at 10 years. Fifteen of 55 patients (27.3%) had recurrent anterior uveitis during the mean follow-up of 4.5 years. The presence of focal posterior synechiae at the diagnosis increased the risk of recurrent anterior uveitis 6.97-fold compared to the absence of synechiae (95% confidence interval [CI], 2.20–22.11; <i>p</i> < 0.001). Use of systemic high-dose steroid therapy more than 7 days after the development of visual symptoms resulted in a hazard ratio of 4.55 (95% CI, 1.27–16.40; <i>p</i> = 0.020).Conclusions: This study reports the estimated incidence and risk factors of recurrent anterior uveitis in VKH disease from survival analyses. However, because of the retrospective nature of this study, it is hard to confirm the consistency of the medical records regarding risk factors, thus, the presence of focal posterior synechiae can be inconclusive as a risk factor. Further studies are warranted.

show abstract

The Incidence and Presentation Features of Glaucoma in Vogt–Koyanagi–Harada Syndrome

Abdelaal,

Hassan,

Katamesh

et al. 2024

Ophthalmology Glaucoma

View full text Add to dashboard Cite

Risk factors for secondary Glaucoma in patients with Vogt-Koyanagi-Harada disease

Cited by 4 publications

References 24 publications

A randomized non-inferiority trial of therapeutic strategy with immunosuppressants versus biologics for Vogt-Koyanagi-Harada disease

A randomized non-inferiority trial of therapeutic strategy with immunosuppressants versus biologics for Vogt-Koyanagi-Harada disease

Incidence and Risk Factors of Recurrent Anterior Uveitis in Initial Acute-Onset Vogt-Koyanagi-Harada Disease

The Incidence and Presentation Features of Glaucoma in Vogt–Koyanagi–Harada Syndrome

Contact Info

Product

Resources

About