Treatments of vogt-koyanagi-harada disease

Abstract

Purpose: To evaluate three therapeutic modalities for Vogt-Koyanagi-Harada (VKH) disease. Cases and Methods: This study was made on 25 cases of VKH disease treated in the past 54 months. Sixteen cases were treated by pulsed corticosteroid, 6 cases by subtenon injection of slow-release steroid, and 3 cases by pulsed steroid followed by subtenon injection. Cases were followed up for 6 months or longer. Results: Total dosis of steroid averaged prednisolone equivalent of 1,372 mg in subtenon group, about 3 times more in cases treated by pulsed steroid, and 5 times more in cases treated by both. The difference was significant. Initial visual acuity was better in eyes treated by subtenon injection only than others. Cases treated by combination of two methods resulted in poorer final visual acuity than others and had an average of two recurrences. Conclusion: Subtenon injection resulted in the same final outcome as pulsed therapy and required lesser dosis of corticosteroid. Combination of both methods was mainly used in severe cases of VKH disease.