Role of intravitreal triamcinolone as an adjuvant in the management of Vogt-Koyanagi-Harada disease

Moreker, Mayur R; Lodhi, Sikander A. K.; Pathengay, Avinash

doi:10.4103/0301-4738.36492

Cited by 13 publications

(6 citation statements)

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“…[4] In chronic stage, there are RPE atrophic areas which can be picked up by indocyanine green angiography. [123456] There were additional retinal changes in the histpathology in our case. Multiple fluid filled pockets were seen in outer retinal layers with photoreceptors degenerations and retinal gliosis.…”

Section: Discussionsupporting

confidence: 48%

“…VKH is a bilateral diffuse panuveitis with multisystem involvement. [12345678910] In this case report, we highlighted in a middle-aged woman affected with bilateral panuveitis with other clinical ocular complications such as corneal edema, shallow anterior chamber, hypotonous right eye and cataract, sunset glow fundus, and CNVM in OS. Histopathology of the right eye showed congested choroidal stromal inflammation with marked thickening of retinochoraoidal complex.…”

Section: Discussionmentioning

confidence: 94%

“…Vogt-Koyanagi-Harada (VKH) disease is a multisystem disorder which includes panuveitis of both the eyes with meninges, ears, and skin involvement. [12345678910] Criteria of VKH was devised and revised time to time. [1234] Clinical course of VKH is varied.…”

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confidence: 99%

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Clinicopathological and immunohistochemistry correlation in a case of Vogt-Koyanagi-Harada disease

Das

Boddepalli

Biswas

2019

Indian J Ophthalmol

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Vogt-Koyanagi-Harada (VKH) disease is a systemic disorder causing bilateral panuveitis. Histopathological documentation along with molecular diagnostic evidence in VKH eye is a rarity. We present a 46-year-old woman with VKH with several ocular complications and subsequently enucleation of the right eye was done because of painful blind eye. Patient had clinical complications of VKH and some of the complications were observed in histopathology. Pathology of the case showed nongranulomatous uveitis, indicating the disease in chronic recurrent stage. Immunohistochemistry showed predominant T-cell involvement in this case. The case showed clinicopathological and immunohistochemistry correlation in a case of VKH disease.

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Section: Discussionsupporting

confidence: 48%

Section: Discussionmentioning

confidence: 94%

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Clinicopathological and immunohistochemistry correlation in a case of Vogt-Koyanagi-Harada disease

Das

Boddepalli

Biswas

2019

Indian J Ophthalmol

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“… 26 Ocular manifestations of VKH can be managed by local administration of steroids. 27 – 29 Moreker and Lodhi, from their study on the use of intravitreal triamcinolone acetonide (IVTA) in VKH, have concluded that IVTA, when used as an adjuvant, can induce remission in the acute stage of VKH and help avoid the long-term use of systemic corticosteroids. 27 Hosoda et al demonstrated that isolated PST is a useful primary treatment option for patients with acute VKH without systemic disorders.…”

Section: Discussionmentioning

confidence: 99%

Clinical spectrum and management options in Vogt–Koyanagi–Harada disease

Lodhi

Reddy

Peram

2017

OPTH

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PurposeThe 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.MethodA 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.ResultsA 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.ConclusionVKH-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.

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“…Behçet’s disease, sarcoidosis ,Vogt-Koyanagi-Harada syndrome and sympathetic ophthalmia, are among others effectively treated with IVTA [11,12,13,14]. Even in such disorders, considered to be autoimmune-driven, a beneficial effect could be achieved.…”

Section: Corticosteroidsmentioning

confidence: 99%

Think Global – Act Local: Intravitreal Drug Delivery Systems in Chronic Noninfectious Uveitis

Hazırolan

Pleyer

2012

Ophthalmic Res

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The eye is probably the most attractive site of the body for treatment using locally delivered therapeutic agents. An ideal indication for such an approach is noninfectious posterior uveitis. Since intraocular structures of the posterior segment are difficult to reach and are otherwise accessible only by systemic treatment, current interest is focused on the pros and cons of intravitreal drug delivery. Because of its chronic and recurrent nature, the long-term release of anti-inflammatory agents is a major treatment goal. Intravitreal injections, intravitreal implants and biodegradable devices are the most commonly used and approved approaches to deliver various agents to the vitreous. Because of their broad and potent effects, corticosteroids (CS) have been the first-line candidates for intraocular delivery. An increasing spectrum of CS preparations including nondegradable and biodegradable devices is currently available. Since repeated and long-term applications bear the risk of steroid-related complications such as increased intraocular pressure and cataract, alternative agents are currently being tested. Intravitreal injection of methotrexate, anti-VEGF (vascular endothelial growth factor), anti-TNFα (tumor necrosis factor α) and sirolimus have also been applied in patients with conflicting results. Intravitreal treatment has significantly reduced the incidence of adverse effects compared to systemic application, but due to greater ocular side effects there are still some limitations.

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Role of intravitreal triamcinolone as an adjuvant in the management of Vogt-Koyanagi-Harada disease

Cited by 13 publications

References 7 publications

Clinicopathological and immunohistochemistry correlation in a case of Vogt-Koyanagi-Harada disease

Clinicopathological and immunohistochemistry correlation in a case of Vogt-Koyanagi-Harada disease

Clinical spectrum and management options in Vogt–Koyanagi–Harada disease

Think Global – Act Local: Intravitreal Drug Delivery Systems in Chronic Noninfectious Uveitis

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Role of intravitreal triamcinolone as an adjuvant in the management of Vogt-Koyanagi-Harada disease

Cited by 13 publications

References 7 publications

Clinicopathological and immunohistochemistry correlation in a case of Vogt-Koyanagi-Harada disease

Clinicopathological and immunohistochemistry correlation in a case of Vogt-Koyanagi-Harada disease

Clinical spectrum and management options in Vogt&ndash;Koyanagi&ndash;Harada disease

Think Global – Act Local: Intravitreal Drug Delivery Systems in Chronic Noninfectious Uveitis

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Clinical spectrum and management options in Vogt–Koyanagi–Harada disease