1. Management of ocular complications of Vogt-Koyanagi-Harada syndrome.
- Author
-
Perente I, Utine CA, Cakir H, Kaya V, Tutkun IT, and Yilmaz OF
- Subjects
- Adolescent, Drug Therapy, Combination, Eye Diseases diagnostic imaging, Eye Diseases etiology, Female, Fluorescein Angiography, Glucocorticoids therapeutic use, Humans, Immunosuppressive Agents therapeutic use, Optic Nerve Diseases diagnostic imaging, Optic Nerve Diseases etiology, Retinal Detachment diagnostic imaging, Retinal Detachment etiology, Tomography, Optical Coherence, Ultrasonography, Uveomeningoencephalitic Syndrome complications, Uveomeningoencephalitic Syndrome diagnostic imaging, Vitreous Body diagnostic imaging, Cyclosporine therapeutic use, Eye Diseases drug therapy, Optic Nerve Diseases drug therapy, Retinal Detachment drug therapy, Triamcinolone Acetonide therapeutic use, Uveomeningoencephalitic Syndrome drug therapy, Vitreous Body pathology
- Abstract
Background: Vogt-Koyanagi-Harada syndrome (VKH) is a multisystem disorder, characterized by the T-cell-mediated autoimmune process directed against melanocytic antigens in the ocular, nervous, auditory and integumentary systems. The ocular hallmarks of the disease involve severe bilateral panuveitis associated with exudative retinal detachment., Case Report: We report a pediatric case of probable VKH Syndrome with isolated ocular findings, in which bilateral vitritis, papillitis and serous retinal detachments involving the macula with intra-retinal edema and choroideal thickening were detected., Intervention: Subtenon triamcinolone acetonide injection was performed in addition to systemic corticosteroid and cyclosporine treatments. Evolution Prompt improvement was seen in the ocular manifestations of VKH syndrome, which persisted for at least 4 months. Subtenon corticosteroid injection, together with systemic corticosteroid and cytotoxic treatment, prevented the ocular complications of invasive intraocular treatment modalities, and at the same time reduced the systemic corticosteroid dosage., Conclusion: We recommend use of ocular invasive treatment modalities in Vogt-Koyanagi-Harada Syndrome only if the disease progression cannot be controlled. If systemic medications fail to stop the progression of the disease activity, subtenon injections may be considered before intraocular treatment modalities.
- Published
- 2009
- Full Text
- View/download PDF