Evaluation of the effect on outcomes of the route of administration of corticosteroids in acute Vogt-Koyanagi-Harada disease.
OBJECTIVE
To compare the effect on outcomes of the route of administration of corticosteroids in acute Vogt-Koyanagi-Harada disease.


METHODS
Retrospective comparative interventional case series.


METHODS



METHODS
Nine international uveitis specialty clinics.


METHODS
Forty-eight patients presenting over a three-year period to a study center with acute Vogt-Koyanagi-Harada disease.


METHODS
Initial treatment with corticosteroid either orally (Oral only group) or intravenously followed by an oral taper (IV+Oral group).


METHODS
Change in visual acuity with treatment; development of ocular complications, including visually significant cataract, choroidal neovascularization, subretinal fibrosis, fundus pigment migration, nummular hypopigmented lesions, and diffuse fundus depigmentation; use of immunosuppressive therapy.


RESULTS
The Oral only group comprised 15 patients (31%) and the IV+Oral group 33 patients (69%). Median follow-up was 15 months. There was no difference in duration of follow-up between groups (P = .234). There was no difference in the change in visual acuity between groups, adjusting for initial visual acuity (P = .402). There were no differences in the rates of development of visually significant cataract, fundus pigmentary changes, or in the rate of use of subsequent immunosuppressive therapy between treatment groups. No patients developed choroidal neovascularization or subretinal fibrosis over the study period.


CONCLUSIONS
Route of administration of corticosteroid had no detectable effect on change in visual acuity nor on the development of visually significant complications over the study period. Prospective trials are necessary to address speed of resolution and definitively answer outcome questions.
Read
Russell W
RW
University of Alabama at Birmingham, Birmingham, Alabama 35233, USA. rwr@uab.edu
Yu
Fei
F
Accorinti
Massimo
M
Bodaghi
Bahram
B
Chee
Soon-Phaik
SP
Fardeau
Christine
C
Goto
Hiroshi
H
Holland
Gary N
GN
Kawashima
Hidetoshi
H
Kojima
Eri
E
Lehoang
Phuc
P
Lemaitre
Claire
C
Okada
Annabelle A
AA
Pivetti-Pezzi
Paola
P
Secchi
Antonio
A
See
Robert F
RF
Tabbara
Khalid F
KF
Usui
Masahiko
M
Rao
Narsing A
NA
D000208:Acute Disease; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage; D012189:Retrospective Studies; D016896:Treatment Outcome; D014607:Uveomeningoencephalitic Syndrome / Q000188:drug therapy* / Q000503:physiopathology; D014792:Visual Acuity / Q000502:physiology
D005938:Glucocorticoids; D011241:Prednisone; D008775:Methylprednisolone