• Users Online: 238
  • Print this page
  • Email this page
REVIEW ARTICLE
Year : 2020  |  Volume : 32  |  Issue : 4  |  Page : 310-314

Vogt–Koyanagi–Harada is a curable autoimmune disease: Early diagnosis and immediate dual steroidal and non-steroidal immunosuppression are crucial prerequisites


1 Retinal and Inflammatory Eye Diseases, Centre For Ophthalmic Specialised Care, Clinic Montchoisi Teaching Centre, Lausanne, Switzerland
2 Department of Ophthalmology, University of Istanbul, Istanbul, Turkey

Correspondence Address:
Carl P Herbort
Retinal and Inflammatory Eye Diseases, Centre for Ophthalmic Specialised Care, Rue Charles.Monnard 6, CH.1003 Lausanne
Switzerland
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JOCO.JOCO_190_20

Rights and Permissions

Purpose: It is crucial to subdivide Vogt–Koyanagi–Harada (VKH) disease into two subentities, initial-onset disease versus chronically evolving disease. For early diagnosis and precise follow-up of VKH choroiditis, the “Revised criteria for VKH” are no more sufficient for the appraisal of VKH and new biomarkers for disease activity are needed. It has been shown that, if initial-onset disease is treated promptly within the “therapeutic window of opportunity” and long enough with dual steroidal and non-steroidal immunosuppression, the disease can be cured in a large proportion of cases, an approach still contested. The proportion of chronic evolution and/or sunset-glow fundus (SGF) following steroidal monotherapy versus dual steroidal and non-steroidal immunosuppression was compared. Methods: A literature search was performed, identifying studies on initial-onset VKH treated either by steroidal monotherapy or dual immunosuppression. Evolution toward chronicity and/or SGF was compared in both groups. Results: Twenty studies were identified with reported long-term outcomes. In 16 studies, 802 patients received steroidal monotherapy, while in 4 studies, 172 patients received dual steroidal and non-steroidal immunosuppression. Chronic evolution and SGF occurred, respectively, in 44% and 59% in the corticosteroid-alone group versus 2.3% and 17.5% in the dual therapy group with no chronic evolution in three studies and no SGF in two studies. Conclusions: Chronic evolution and SGF are significantly less frequent in initial-onset VKH when treated with immediate dual steroidal and non-steroidal immunosuppression with a high proportion of healed cases. This combined approach seems recommended in the management of initial-onset VKH disease.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed647    
    Printed56    
    Emailed0    
    PDF Downloaded84    
    Comments [Add]    

Recommend this journal