Periyanayagi Murugananthan1 , Maria Deepika Krishna Moorthi2 , Arthi Mohankumar3
BACKGROUND This is a bilateral condition where there is a chronic granulomatous iridocyclitis with an exudative choroiditis which often leads to an exudative detachment of the retina. We wanted to study the demographic features, and the clinical outcomes in patients of Vogt-Koyanagi Harada Disease. METHODS This is a prospective study in which patients between 8 and 50 years were seen and treated at RIO-GOH, Chennai, from 2008 to 2018, and followed-up subsequently. All patients were treated with a dose of bolus of intravenous methylprednisolone for 3 days followed by high-dose oral prednisolone. Few patients needed further intervention with immunosuppressants. One patient treated with immunosuppressants required further injections of anti-VEGF when he further developed choroidal neovascularisation. Periodic review of the patients was done monthly for assessing reduction of the vitreous inflammation and assessing the response to treatment. RESULTS Most patients responded well to steroids and there was less recurrence of inflammation. Few patients had repeated episodes and were started on immunosuppressants. Some of them were started on azathioprine and few of them needed cyclosporine and mycophenolate mofetil. One patient further developed choroidal neovascular membrane, and injection Anti-VEGF was administered to reduce complications. CONCLUSIONS IV methylprednisolone followed by oral prednisolone is a first line approach to Immunosuppression where there is steroid intolerance or inadequate response to steroid.
