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Prognostic factors for clinical outcomes in patients with Vogt‐Koyanagi‐Harada disease treated with high‐dose corticosteroids
Author(s) -
ABU EL ASRAR A
Publication year - 2013
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/j.1755-3768.2013.2254.x
Subject(s) - medicine , vogt–koyanagi–harada disease , visual acuity , presentation (obstetrics) , disease , surgery , ophthalmology
Purpose: To determine prognostic factors in patients with Vogt‐Koyanagi‐Harada (VKH) disease who were treated with high‐dose corticosteroids. Methods: Analysis of 87 patients (174 eyes). Results: Chronic recurrent presentation was significantly associated with more severe anterior segment inflammation at presentation as indicated by presence of mutton‐fat keratic precipitates, anterior chamber reaction of 2+ or more, iris nodules and posterior synechiae, less exudative retinal detachment at presentation, more complications during the follow‐up period and a worse visual outcome. The use of immunomodulatory therapy as first line therapy significantly reduced the development of complications in the whole study group and in initial‐onset acute group and improved visual outcome in the whole study group. In the whole study group, final visual acuity of 20/20 was significantly associated with good initial visual acuity of >20/200 and age older than 16 years was significantly associated with the development of complications. Conclusions: Chronic recurrent VKH disease is significantly associated with more severe inflammation at presentation and more complications. Use of immunomodulatory therapy improves clinical outcome.