[Vogt-Koyanagi-Harada syndrome (clinical cases)].

Abstract

OBJECTIVE:

to analyze two female cases of Vogt-Koyanagi-Harada (VKH) syndrome.

MATERIAL AND METHODS:

The first patient presented with bilateral panuveitis and unilateral keratomalacia (left eye). For the latter, blepharorrhaphy was performed. Methylprednisolone (Metypred) and azathioprine pulses, subsequently switched to oral therapy, caused regression of uveitis. In 1 month the patient was operated for retinal detachment and associated cataract in her right eye. The second patient presented with bilateral detachment of neuroepithelium. Complete reattachment in both eyes was achieved with Metypred pulses followed by oral prednisolone and azathioprine. Bilateral panuveitis with pupil occlusion developed 6 months after the cessation of prednisolone, however, began to resolve as soon as the treatment was resumed.

RESULTS:

Timely diagnosis and combination pulse therapy (methylprednisolone and azathioprine) enabled rapid resolution of acute condition.

CONCLUSIONS:

Pulse Metypred is the mainstay of the treatment of VKH syndrome. Supplementing the treatment of autoimmune uveitis with low doses of azathioprine slows progression of the disease and minimizes prednisolone-induced side effects. It is important that VKH patients are treated with pathogenetic therapy in close cooperation with an immunologist. Long-term monitoring (not less than 2-3 years) is also necessary.

• Authors: E L Sorokin, N V Voronina, S Yu Avramenko, N V Pomytkina
• Journal: Vestnik oftalmologii (Vestn Oftalmol) 2015 May-Jun Vol. 131 Issue 3 Pg. 90-98 ISSN: 0042-465X [Print] Russia (Federation)
• PMID: 26310014 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Glucocorticoids
• Methylprednisolone

Topics

• Disease Progression
• Dose-Response Relationship, Drug
• Female
• Glucocorticoids (administration & dosage)
• Humans
• Methylprednisolone (administration & dosage)
• Middle Aged
• Tomography, Optical Coherence
• Uveomeningoencephalitic Syndrome (diagnosis, drug therapy, physiopathology)
• Visual Acuity