Un Chul Park1, In Hwan Cho1, Eun Kyung Lee1, Hyeong Gon Yu2,3. 1. Department of Ophthalmology, College of Medicine, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, 110-799, South Korea. 2. Department of Ophthalmology, College of Medicine, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, 110-799, South Korea. hgonyu@snu.ac.kr. 3. Sensory Organs Institute, Medical Research Center, Seoul National University, Seoul, South Korea. hgonyu@snu.ac.kr.
Abstract
PURPOSE: To determine whether route of corticosteroid administration during the acute stage of Vogt-Koyanagi-Harada (VKH) disease affects depigmentary change and subfoveal choroidal thickness (SCT) during the convalescent stage. METHODS: In this retrospective comparative study, VKH patients with the interval between diagnosis and final follow-up of ≥ 24 months were divided into two groups according to route of systemic corticosteroid; intravenous pulse therapy (IV pulse group) and oral administration (oral group). Sunset glow fundus (SGF) scores determined by ultra-wide field retinal imaging and SCT determined by enhanced depth imaging optical coherence tomography were compared. RESULTS: Forty eyes (20 patients) were included in the IV pulse group and 33 eyes (18 patients) in the oral group. At final follow-up, the IV pulse group showed significantly lower mean SGF score, indicating less advanced depigmentary change (3.7 ± 1.5 vs. 5.1 ± 1.2, P = 0.007) and greater mean SCT (239.7 ± 71.1 μm vs. 183.8 ± 72.6 μm, P = 0.012) than the oral group. However, visual acuities did not differ (P = 0.245). In a cross-sectional evaluation at multiple time points from disease onset, the IV pulse group showed significantly lower SGF scores from 1 to 6 years and greater SCTs from 2 to 5 years. Multivariable regression analysis showed that IV pulse therapy and less frequent and shorter duration of inflammation predicted a lower SGF score (R2 = 0.291, P < 0.001), and young age, IV pulse therapy, and shorter duration of inflammation predicted greater SCT (R2 = 0.27, P < 0.001). CONCLUSIONS: Compared to oral administration, high dose IV pulse corticosteroids during the acute stage of VKH disease resulted in less choroidal change during the convalescent stage.
PURPOSE: To determine whether route of corticosteroid administration during the acute stage of Vogt-Koyanagi-Harada (VKH) disease affects depigmentary change and subfoveal choroidal thickness (SCT) during the convalescent stage. METHODS: In this retrospective comparative study, VKHpatients with the interval between diagnosis and final follow-up of ≥ 24 months were divided into two groups according to route of systemic corticosteroid; intravenous pulse therapy (IV pulse group) and oral administration (oral group). Sunset glow fundus (SGF) scores determined by ultra-wide field retinal imaging and SCT determined by enhanced depth imaging optical coherence tomography were compared. RESULTS: Forty eyes (20 patients) were included in the IV pulse group and 33 eyes (18 patients) in the oral group. At final follow-up, the IV pulse group showed significantly lower mean SGF score, indicating less advanced depigmentary change (3.7 ± 1.5 vs. 5.1 ± 1.2, P = 0.007) and greater mean SCT (239.7 ± 71.1 μm vs. 183.8 ± 72.6 μm, P = 0.012) than the oral group. However, visual acuities did not differ (P = 0.245). In a cross-sectional evaluation at multiple time points from disease onset, the IV pulse group showed significantly lower SGF scores from 1 to 6 years and greater SCTs from 2 to 5 years. Multivariable regression analysis showed that IV pulse therapy and less frequent and shorter duration of inflammation predicted a lower SGF score (R2 = 0.291, P < 0.001), and young age, IV pulse therapy, and shorter duration of inflammation predicted greater SCT (R2 = 0.27, P < 0.001). CONCLUSIONS: Compared to oral administration, high dose IV pulse corticosteroids during the acute stage of VKH disease resulted in less choroidal change during the convalescent stage.
Authors: R W Read; G N Holland; N A Rao; K F Tabbara; S Ohno; L Arellanes-Garcia; P Pivetti-Pezzi; H H Tessler; M Usui Journal: Am J Ophthalmol Date: 2001-05 Impact factor: 5.258
Authors: Massimo Accorinti; Maria Carmela Saturno; Ludovico Iannetti; Priscilla Manni; Davide Mastromarino; Maria Pia Pirraglia Journal: J Clin Med Date: 2022-06-23 Impact factor: 4.964