Abstract | PURPOSE: DESIGN: Retrospective, interventional case series. METHODS: Patients with VKH seen at Singapore National Eye Centre from 2008-2018 were studied. The standardized clinical protocol was intravenous methyl prednisolone followed by/or oral prednisolone 1 mg/kg daily with slow taper plus IMT within 3 months. We collected data on demographics, clinical features, and indocyanine green angiography (ICGA). Uveitis activity was assessed clinically and by ICGA. Results were compared when IMT was given before vs after 6 weeks (late IMT) and with historical data (IMT added when uveitis uncontrolled). RESULTS: Fifty-eight eyes of 29 patients were studied. Half of the patients were Chinese (15, 51.7%). The mean age ± standard deviation was 42.2 ± 13.3 years. Twenty-five patients required 1 IMT and 4 needed 2 drugs. Sunset glow fundus occurred in 34 of 58 eyes (58.6%). Uveitis resolved in 24 of 58 eyes (41.4%), became chronic in 30 (51.7%), and required chronic recurrent in 4 eyes (6.9%). Eyes with IMT initiated within 6 weeks had better visual outcome that was significant at 4 years (P = .036; Mann-Whitney U test) but had a similar occurrence of sunset glow fundus and uveitis. Compared with historical data, visual outcome was better and was significant at 3 years (P = .04; t test), and significantly fewer patients developed chronic recurrent disease (P < .001; χ2 test). CONCLUSION: High-dose corticosteroids with IMT within 3 months resulted in improved visual outcomes and a reduced risk of developing chronic recurrent uveitis compared with IMT given as clinically indicated.
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Authors | Ei Ei Lin Oo, Soon-Phaik Chee, Kelvin Kin Yan Wong, Hla Myint Htoon |
Journal | American journal of ophthalmology
(Am J Ophthalmol)
Vol. 220
Pg. 37-44
(12 2020)
ISSN: 1879-1891 [Electronic] United States |
PMID | 32738228
(Publication Type: Journal Article)
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Copyright | Copyright © 2020 Elsevier Inc. All rights reserved. |
Chemical References |
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Topics |
- Adult
- Disease Management
- Female
- Fluorescein Angiography
(methods)
- Follow-Up Studies
- Fundus Oculi
- Humans
- Immunomodulation
- Immunosuppressive Agents
(therapeutic use)
- Male
- Middle Aged
- Retrospective Studies
- Uveomeningoencephalitic Syndrome
(diagnosis, drug therapy)
- Visual Acuity
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