Outcomes of patients with acute Vogt-Koyanagi-Harada disease treated with intravenous corticosteroid pulse followed by the slow tapering of oral corticosteroid therapy.
Corticosteroid pulse therapy
Recurrence
Visual outcome
Vogt–Koyanagi–Harada disease
Journal
International ophthalmology
ISSN: 1573-2630
Titre abrégé: Int Ophthalmol
Pays: Netherlands
ID NLM: 7904294
Informations de publication
Date de publication:
Feb 2023
Feb 2023
Historique:
received:
23
12
2021
accepted:
05
07
2022
pubmed:
23
7
2022
medline:
3
3
2023
entrez:
22
7
2022
Statut:
ppublish
Résumé
To elucidate the intravenous corticosteroid pulse treatment outcomes of patients with acute Vogt-Koyanagi-Harada (VKH) disease and assess the differences between patients with no inflammation worsening and those with persistent or worsening inflammation. Potential factors responsible for eyes with low visual outcomes were also investigated. We retrospectively reviewed the clinical records of patients with acute VKH disease who first visited us between 2009 and 2018 and were followed up for > 300 days. Clinical characteristics, treatments, and posttreatment conditions were assessed. Patients were classified into no inflammation worsening (acute-resolved [AR]) and inflammation worsening (chronic-recurrent [CR]) groups based on conditions after 6 months from disease onset. This study included 60 eyes from 30 patients (mean age: 52.7 years). Patients were treated with methylprednisolone pulse followed by the slow tapering of oral prednisolone; 73% of patients developed AR and 27% CR, and the best-corrected visual acuity (BCVA) was ≥ 1.0 in 83% of eyes at 6 months following the introduction of treatment. Although the total prednisolone dose was higher in patients with CR disease, no significant difference was noted in the final BCVA. Among the patients, five eyes had a final BCVA of ≤ 0.5 due to anisometropic amblyopia, diabetic maculopathy, pre-existing macular hole, epiretinal membrane, and ellipsoid zone loss. Patients with acute VKH disease treated with corticosteroid pulse appear to demonstrate good visual outcomes, including patients with CR; the majority of eyes with low visual outcomes have pre-existing conditions that explain the low vision.
Identifiants
pubmed: 35869402
doi: 10.1007/s10792-022-02440-0
pii: 10.1007/s10792-022-02440-0
doi:
Substances chimiques
Glucocorticoids
0
Methylprednisolone
X4W7ZR7023
Adrenal Cortex Hormones
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
431-440Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Nature B.V.
Références
Kobayashi H, Kokubo T, Takahashi M, Sato K, Miyokawa N, Kimura S, Kinouchi R, Katagiri M (1998) Tyrosinase epitope recognized by an HLA-DR-restricted T-cell line from a Vogt-Koyanagi-Harada disease patient. Immunogenetics 47:398–403. https://doi.org/10.1007/s002510050375
doi: 10.1007/s002510050375
pubmed: 9510558
O’Keefe GA, Rao NA (2017) Vogt-Koyanagi-Harada disease. Surv Ophthalmol 62:1–25. https://doi.org/10.1016/j.survophthal.2016.05.002
doi: 10.1016/j.survophthal.2016.05.002
pubmed: 27241814
Norose K, Yano A (1996) Melanoma specific Th1 cytotoxic T lymphocyte lines in Vogt-Koyanagi-Harada disease. Br J Ophthalmol 80:1002–1008. https://doi.org/10.1136/bjo.80.11.1002
doi: 10.1136/bjo.80.11.1002
pubmed: 8976730
pmcid: 505680
Baltmr A, Lightman S, Tomkins-Netzer O (2016) Vogt-Koyanagi-Harada syndrome - current perspectives. Clin Ophthalmol 10:2345–2361. https://doi.org/10.2147/OPTH.S94866
doi: 10.2147/OPTH.S94866
pubmed: 27932857
pmcid: 5135404
Rubsamen PE, Gass JDM (1991) Vogt-Koyanagi-Harada syndrome: clinical course, therapy, and long-term visual outcome. Arch Ophthalmol 109:682–687. https://doi.org/10.1001/archopht.1991.01080050096037
doi: 10.1001/archopht.1991.01080050096037
pubmed: 2025171
Chee SP, Jap A, Bacsal K (2009) Prognostic factors of Vogt-Koyanagi-Harada disease in Singapore. Am J Ophthalmol 147(154–161):e151. https://doi.org/10.1016/j.ajo.2008.07.044
doi: 10.1016/j.ajo.2008.07.044
Kitaichi N, Horie Y, Ohno S (2008) Prompt therapy reduces the duration of systemic corticosteroids in Vogt-Koyanagi-Harada disease. Graefes Arch Clin Exp Ophthalmol 246:1641–1642. https://doi.org/10.1007/s00417-008-0869-5
doi: 10.1007/s00417-008-0869-5
pubmed: 18563429
Sasamoto Y, Ohno S, Matsuda H (1990) Studies on corticosteroid therapy in Vogt-Koyanagi-Harada disease. Ophthalmologica 201:162–167. https://doi.org/10.1159/000310145
doi: 10.1159/000310145
pubmed: 2089358
Lai TY, Chan RP, Chan CK, Lam DS (2009) Effects of the duration of initial oral corticosteroid treatment on the recurrence of inflammation in Vogt-Koyanagi-Harada disease. Eye (Lond) 23:543–548. https://doi.org/10.1038/eye.2008.89
doi: 10.1038/eye.2008.89
pubmed: 18369377
Read RW, Rechodouni A, Butani N, Johnston R, LaBree LD, Smith RE, Rao NA (2001) Complications and prognostic factors in Vogt-Koyanagi-Harada disease. Am J Ophthalmol 131:599–606. https://doi.org/10.1016/s0002-9394(01)00937-0
doi: 10.1016/s0002-9394(01)00937-0
pubmed: 11336934
Nakayama M, Keino H, Watanabe T, Okada AA (2019) Clinical features and visual outcomes of 111 patients with new-onset acute Vogt-Koyanagi-Harada disease treated with pulse intravenous corticosteroids. Br J Ophthalmol 103:274–278. https://doi.org/10.1136/bjophthalmol-2017-311691
doi: 10.1136/bjophthalmol-2017-311691
pubmed: 29666121
Sakata VM, da Silva FT, Hirata CE, Marin ML, Rodrigues H, Kalil J, Costa RA, Yamamoto JH (2015) High rate of clinical recurrence in patients with Vogt-Koyanagi-Harada disease treated with early high-dose corticosteroids. Graefes Arch Clin Exp Ophthalmol 253:785–790. https://doi.org/10.1007/s00417-014-2904-z
doi: 10.1007/s00417-014-2904-z
pubmed: 25592477
Russell W. Read M, Gary N. Holland, MD, Narsing A. Rao, MD,, Khalid F. Tabbara M, Shigeaki Ohno, MD, Lourdes Arellanes-Garcia, MD, Paola pivetti-pezZI, MD, Howard H. Tessler, MD, and Masahiko USUI, MD (2001) Revised Diagnostic Criteria for Vogt-Koyanagi-Harada Disease: Report of an International Committee on Nomenclature. Am J Ophthalmol
Suzuki Y, Nawata H, Soen S, Fujiwara S, Nakayama H, Tanaka I, Ozono K, Sagawa A, Takayanagi R, Tanaka H, Miki T, Masunari N, Tanaka Y (2014) Guidelines on the management and treatment of glucocorticoid-induced osteoporosis of the Japanese Society for Bone and Mineral Research: 2014 update. J Bone Miner Metab 32:337–350. https://doi.org/10.1007/s00774-014-0586-6
doi: 10.1007/s00774-014-0586-6
pubmed: 24818875
Jabs DA, Nussenblatt RB, Rosenbaum JT (2005) Standardization of uveitis nomenclature for reporting clinical data. results of the first international workshop. Am J Ophthalmol 140:509–516. https://doi.org/10.1016/j.ajo.2005.03.057
doi: 10.1016/j.ajo.2005.03.057
pubmed: 16196117
Kanda Y (2013) Investigation of the freely available easy-to-use software “EZR” for medical statistics. Bone Marrow Transplant 48:452–458. https://doi.org/10.1038/bmt.2012.244
doi: 10.1038/bmt.2012.244
pubmed: 23208313
Read RW, Holland GN, Rao NA, Tabbara KF, Ohno S, Arellanes-Garcia L, Pivetti-Pezzi P, Tessler HH, Usui M (2001) Revised diagnostic criteria for Vogt-Koyanagi-Harada disease: report of an international committee on nomenclature. Am J Ophthalmol 131:647–652. https://doi.org/10.1016/s0002-9394(01)00925-4
doi: 10.1016/s0002-9394(01)00925-4
pubmed: 11336942
Shen E, Rathinam SR, Babu M, Kanakath A, Thundikandy R, Lee SM, Browne EN, Porco TC, Acharya NR (2016) Outcomes of Vogt-Koyanagi-Harada disease: a subanalysis from a randomized clinical trial of antimetabolite therapies. Am J Ophthalmol 168:279–286. https://doi.org/10.1016/j.ajo.2016.06.004
doi: 10.1016/j.ajo.2016.06.004
pubmed: 27296490
pmcid: 4969141
Yang P, Liu S, Zhong Z, Du L, Ye Z, Zhou W, Kijlstra A (2019) Comparison of clinical features and visual outcome between sympathetic Ophthalmia and Vogt-Koyanagi-Harada disease in chinese patients. Ophthalmology 126:1297–1305. https://doi.org/10.1016/j.ophtha.2019.03.049
doi: 10.1016/j.ophtha.2019.03.049
pubmed: 30959067
Giordano VE, Schlaen A, Guzman-Sanchez MJ, Couto C (2017) Spectrum and visual outcomes of Vogt-Koyanagi-Harada disease in Argentina. Int J Ophthalmol 10:98–102. https://doi.org/10.18240/ijo.2017.01.16
doi: 10.18240/ijo.2017.01.16
pubmed: 28149784
pmcid: 5225356
Arevalo JF, Lasave AF, Gupta V, Kozak I, Al Harbi MB, Al Rushood AA, Al Dhibi HA (2016) Clinical outcomes of patients with Vogt-Koyanagi-Harada disease over 12 years at a tertiary center. Ocul Immunol Inflamm 24:521–529. https://doi.org/10.3109/09273948.2015.1025984
doi: 10.3109/09273948.2015.1025984
pubmed: 26399962
Iwahashi C, Okuno K, Hashida N, Nakai K, Ohguro N, Nishida K (2015) Incidence and clinical features of recurrent Vogt-Koyanagi-Harada disease in Japanese individuals. Jpn J Ophthalmol 59:157–163. https://doi.org/10.1007/s10384-015-0377-1
doi: 10.1007/s10384-015-0377-1
pubmed: 25808016
Rao NA, Sukavatcharin S, Tsai JH (2007) Vogt-Koyanagi-Harada disease diagnostic criteria. Int Ophthalmol 27:195–199. https://doi.org/10.1007/s10792-006-9021-x
doi: 10.1007/s10792-006-9021-x
pubmed: 17384920
Kitamura M, Takami K, Kitaichi N, Namba K, Kitamei H, Kotake S, Ohno S (2005) Comparative study of two sets of criteria for the diagnosis of Vogt-Koyanagi-Harada’s disease. Am J Ophthalmol 139:1080–1085. https://doi.org/10.1016/j.ajo.2005.01.046
doi: 10.1016/j.ajo.2005.01.046
pubmed: 15953440
Ikeda N, Kojima H, Nishikawa M, Hayashi K, Futagami T, Tsujino T, Kusunoki Y, Fujii N, Suegami S, Miyazaki Y, Middleton D, Tanaka H, Saji H (2015) Determination of HLA-A, -C, -B, -DRB1 allele and haplotype frequency in Japanese population based on family study. Tissue Antigens 85:252–259. https://doi.org/10.1111/tan.12536
doi: 10.1111/tan.12536
pubmed: 25789826
pmcid: 5054903
Shindo Y, Ohno S, Yamamoto T, Nakamura S, Inoko H (1994) Complete association of the HLA-DRB1 ∗04 and -DQB1 ∗04 alleles with Vogt-Koyanagi-Harada’s disease. Hum Immunol 39:169–176. https://doi.org/10.1016/0198-8859(94)90257-7
doi: 10.1016/0198-8859(94)90257-7
pubmed: 8026985
Read RW, Yu F, Accorinti M, Bodaghi B, Chee SP, Fardeau C, Goto H, Holland GN, Kawashima H, Kojima E, Lehoang P, Lemaitre C, Okada AA, Pivetti-Pezzi P, Secchi A, See RF, Tabbara KF, Usui M, Rao NA (2006) Evaluation of the effect on outcomes of the route of administration of corticosteroids in acute Vogt-Koyanagi-Harada disease. Am J Ophthalmol 142:119–124. https://doi.org/10.1016/j.ajo.2006.02.049
doi: 10.1016/j.ajo.2006.02.049
pubmed: 16815259
Park UC, Cho IH, Lee EK, Yu HG (2017) The effect on choroidal changes of the route of systemic corticosteroids in acute Vogt-Koyanagi-Harada disease. Graefes Arch Clin Exp Ophthalmol 255:1203–1211. https://doi.org/10.1007/s00417-017-3654-5
doi: 10.1007/s00417-017-3654-5
pubmed: 28382438
Herbort CP Jr, Abu El Asrar AM, Yamamoto JH, Pavésio CE, Gupta V, Khairallah M, Tugal-Tutkun I, Soheilian M, Takeuchi M, Papadia M (2017) Reappraisal of the management of Vogt-Koyanagi-Harada disease: sunset glow fundus is no more a fatality. Int Ophthalmol 37:1383–1395. https://doi.org/10.1007/s10792-016-0395-0
doi: 10.1007/s10792-016-0395-0
pubmed: 27844182
White KP, Driscoll MS, Rothe MJ, Grant-Kels JM (1994) Severe adverse cardiovascular effects of pulse steroid therapy: is continuous cardiac monitoring necessary? J Am Acad Dermatol 30:768–773. https://doi.org/10.1016/s0190-9622(08)81508-3
doi: 10.1016/s0190-9622(08)81508-3
pubmed: 8176017