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Mycophenolate mofetil combined with systemic corticosteroids prevents progression to chronic recurrent inflammation and development of ‘sunset glow fundus’ in initial‐onset acute uveitis associated with Vogt–Koyanagi–Harada disease
Author(s) -
Abu ElAsrar Ahmed M.,
Dosari Mona,
Hemachandran Suhail,
Gikandi Priscilla W.,
AlMuammar Abdulrahman
Publication year - 2017
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.13189
Subject(s) - medicine , vogt–koyanagi–harada disease , uveitis , fundus (uterus) , visual acuity , corticosteroid , surgery , ophthalmology
Purpose To evaluate the effectiveness and safety of mycophenolate mofetil ( MMF ) as first‐line therapy combined with systemic corticosteroids in initial‐onset acute uveitis associated with Vogt–Koyanagi–Harada ( VKH ) disease. Methods This prospective study included 38 patients (76 eyes). The main outcome measures were final visual acuity, corticosteroid‐sparing effect, progression to chronic recurrent granulomatous uveitis and development of complications, particularly ‘sunset glow fundus’. Results The mean follow‐up period was 37.0 ± 29.3 (range 9–120 months). Visual acuity of 20/20 was achieved by 93.4% of the eyes. Corticosteroid‐sparing effect was achieved in all patients. The mean interval between starting treatment and tapering to 10 mg or less daily was 3.8 ± 1.3 months (range 3–7 months). Twenty‐two patients (57.9%) discontinued treatment without relapse of inflammation. The mean time observed off of treatment was 28.1 ± 19.6 months (range 1–60 months). None of the eyes progressed to chronic recurrent granulomatous uveitis. The ocular complications encountered were glaucoma in two eyes (2.6%) and cataract in five eyes (6.6%). None of the eyes developed ‘sunset glow fundus’, and none of the patients developed any systemic adverse events associated with the treatment. Conclusions Use of MMF as first‐line therapy combined with systemic corticosteroids in patients with initial‐onset acute VKH disease prevents progression to chronic recurrent granulomatous inflammation and development of ‘sunset glow fundus’.