title: Evaluation of the effect on outcomes of the route of administration of corticosteroids in acute Vogt-Koyanagi-Harada disease.
abstract: 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.
authors.affiliation: University of Alabama at Birmingham, Birmingham, Alabama 35233, USA. rwr@uab.edu
authors.forename: Russell W
authors.initials: RW
authors.lastname: Read
authors.forename: Fei
authors.initials: F
authors.lastname: Yu
authors.forename: Massimo
authors.initials: M
authors.lastname: Accorinti
authors.forename: Bahram
authors.initials: B
authors.lastname: Bodaghi
authors.forename: Soon-Phaik
authors.initials: SP
authors.lastname: Chee
authors.forename: Christine
authors.initials: C
authors.lastname: Fardeau
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Goto
authors.forename: Gary N
authors.initials: GN
authors.lastname: Holland
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Kawashima
authors.forename: Eri
authors.initials: E
authors.lastname: Kojima
authors.forename: Phuc
authors.initials: P
authors.lastname: Lehoang
authors.forename: Claire
authors.initials: C
authors.lastname: Lemaitre
authors.forename: Annabelle A
authors.initials: AA
authors.lastname: Okada
authors.forename: Paola
authors.initials: P
authors.lastname: Pivetti-Pezzi
authors.forename: Antonio
authors.initials: A
authors.lastname: Secchi
authors.forename: Robert F
authors.initials: RF
authors.lastname: See
authors.forename: Khalid F
authors.initials: KF
authors.lastname: Tabbara
authors.forename: Masahiko
authors.initials: M
authors.lastname: Usui
authors.forename: Narsing A
authors.initials: NA
authors.lastname: Rao
mesh_terms: 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
chemical_list: D005938:Glucocorticoids; D011241:Prednisone; D008775:Methylprednisolone