Vogt-Koyanagi-Harada syndrome. Clinical course, therapy, and long-term visual outcome.
We reviewed data from 26 patients with Vogt-Koyanagi-Harada syndrome who presented at the Bascom Palmer Eye Institute between March 1969 and February 1990. Visual outcomes were good, with final visual acuity of better than 20/30 in 29 (66%) of 44 eyes and of worse than 20/400 in only three (7%) of 44 eyes. A poor prognosis was associated with the development of choroidal neovascular membranes or chronic uveitis. All patients were treated with systemic corticosteroids. Corticosteroid therapy averaged 6 months, but was prolonged (48 months) in patients who developed chronic uveitis. Disease recurred in nine (43%) of 21 patients in the first 3 months, usually in association with a rapid tapering of steroid dosage. We recommend the early, aggressive use of systemic corticosteroids in patients with Vogt-Koyanagi-Harada syndrome and a gradual tapering of drug dosage for 6 months after presentation.
Rubsamen
P E
PE
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, School of Medicine, FL 33101.
Gass
J D
JD
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D014603:Uveal Diseases / Q000209:etiology; D014607:Uveomeningoencephalitic Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D014792:Visual Acuity
D000305:Adrenal Cortex Hormones