Top

Graefe's Archive for Clinical and Experimental Ophthalmology

Published in:

01-06-2017 | Inflammatory Disorders

The effect on choroidal changes of the route of systemic corticosteroids in acute Vogt-Koyanagi-Harada disease

Authors: Un Chul Park, In Hwan Cho, Eun Kyung Lee, Hyeong Gon Yu

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 6/2017

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.

Moorthy RS, Inomata H, Rao NA (1995) Vogt-Koyanagi-Harada syndrome. Surv Ophthalmol 39(4):265–292CrossRefPubMed

Maruko I, Iida T, Sugano Y, Oyamada H, Sekiryu T, Fujiwara T, Spaide RF (2011) Subfoveal choroidal thickness after treatment of Vogt-Koyanagi-Harada disease. Retina 31(3):510–517. doi:10.1097/IAE.0b013e3181eef053 CrossRefPubMed

Herbort CP, Mantovani A, Bouchenaki N (2007) Indocyanine green angiography in Vogt-Koyanagi-Harada disease: angiographic signs and utility in patient follow-up. Int Ophthalmol 27(2–3):173–182. doi:10.1007/s10792-007-9060-y CrossRefPubMed

Inomata H, Rao NA (2001) Depigmented atrophic lesions in sunset glow fundi of Vogt-Koyanagi-Harada disease. Am J Ophthalmol 131(5):607–614CrossRefPubMed

Inomata H, Sakamoto T (1990) Immunohistochemical studies of Vogt-Koyanagi-Harada disease with sunset sky fundus. Curr Eye Res 9(Suppl):35–40CrossRefPubMed

da Silva FT, Sakata VM, Nakashima A, Hirata CE, Olivalves E, Takahashi WY, Costa RA, Yamamoto JH (2013) Enhanced depth imaging optical coherence tomography in long-standing Vogt-Koyanagi-Harada disease. Br J Ophthalmol 97(1):70–74. doi:10.1136/bjophthalmol-2012-302089 CrossRefPubMed

Takahashi H, Takase H, Ishizuka A, Miyanaga M, Kawaguchi T, Ohno-Matsui K, Mochizuki M (2014) Choroidal thickness in convalescent vogt-koyanagi-harada disease. Retina 34(4):775–780. doi:10.1097/IAE.0b013e3182a6b3f6 CrossRefPubMed

Chee SP, Jap A, Bacsal K (2009) Prognostic factors of Vogt-Koyanagi-Harada disease in Singapore. Am J Ophthalmol 147(1):154–161 . doi:10.1016/j.ajo.2008.07.044 e151CrossRefPubMed

Jap A, Luu CD, Yeo I, Chee SP (2008) Correlation between peripapillary atrophy and corticosteroid therapy in patients with Vogt-Koyanagi-Harada disease. Eye 22(2):240–245. doi:10.1038/sj.eye.6702591 CrossRefPubMed

10.

Read RW, Yu F, Accorinti M, Bodaghi B, Chee SP, Fardeau C, Goto H, Holland GN, Kawashima H, Kojima E, Lehoang P, Lemaitre C, Okada AA, Pivetti-Pezzi P, Secchi A, See RF, Tabbara KF, Usui M, Rao NA (2006) Evaluation of the effect on outcomes of the route of administration of corticosteroids in acute Vogt-Koyanagi-Harada disease. Am J Ophthalmol 142(1):119–124. doi:10.1016/j.ajo.2006.02.049 CrossRefPubMed

11.

Yamanaka E, Ohguro N, Yamamoto S, Nakagawa Y, Imoto Y, Tano Y (2002) Evaluation of pulse corticosteroid therapy for vogt-koyanagi-harada disease assessed by optical coherence tomography. Am J Ophthalmol 134(3):454–456CrossRefPubMed

12.

Guo YL, Du Y, He JF (2009) Correlation between sunset glow fundus and initial dosage of corticosteroid in patients with Vogt-Koyanagi-Harada disease. Am J Ophthalmol 147(5):946 . doi:10.1016/j.ajo.2009.02.005author reply 946-947CrossRefPubMed

13.

Lee EK, Lee SY, Yu HG (2015) A clinical grading system based on ultra-wide field retinal imaging for sunset glow fundus in Vogt-Koyanagi-Harada disease. Graefes Arch Clin Exp Ophthalmol 253(3):359–368. doi:10.1007/s00417-014-2710-7 CrossRefPubMed

14.

Read RW, Holland GN, Rao NA, Tabbara KF, Ohno S, Arellanes-Garcia L, Pivetti-Pezzi P, Tessler HH, Usui M (2001) Revised diagnostic criteria for Vogt-Koyanagi-Harada disease: report of an international committee on nomenclature. Am J Ophthalmol 131(5):647–652CrossRefPubMed

15.

Holland GN, Buhles WC Jr, Mastre B, Kaplan HJ (1989) A controlled retrospective study of ganciclovir treatment for cytomegalovirus retinopathy. Use of a standardized system for the assessment of disease outcome. UCLA CMV retinopathy. Study group. Arch Ophthalmol 107(12):1759–1766CrossRefPubMed

16.

Maezawa N, Yano A, Taniguchi M, Kojima S (1982) The role of cytotoxic T lymphocytes in the pathogenesis of Vogt-Koyanagi-Harada disease. Ophthalmologica 185(3):179–186CrossRefPubMed

17.

Chee SP, Luu CD, Cheng CL, Lim WK, Jap A (2005) Visual function in Vogt-Koyanagi-Harada patients. Graefes Arch Clin Exp Ophthalmol 243(8):785–790. doi:10.1007/s00417-005-1156-3 CrossRefPubMed

18.

Keino H, Goto H, Mori H, Iwasaki T, Usui M (2006) Association between severity of inflammation in CNS and development of sunset glow fundus in Vogt-Koyanagi-Harada disease. Am J Ophthalmol 141(6):1140–1142. doi:10.1016/j.ajo.2006.01.017 CrossRefPubMed

19.

Nazari H, Hariri A, Hu Z, Ouyang Y, Sadda S, Rao NA (2014) Choroidal atrophy and loss of choriocapillaris in convalescent stage of Vogt-Koyanagi-Harada disease: in vivo documentation. J Ophthalmic Inflamm Infect 4:9. doi:10.1186/1869-5760-4-9 CrossRefPubMedPubMedCentral

20.

Fong AH, Li KK, Wong D (2011) Choroidal evaluation using enhanced depth imaging spectral-domain optical coherence tomography in Vogt-Koyanagi-Harada disease. Retina 31(3):502–509. doi:10.1097/IAE.0b013e3182083beb CrossRefPubMed

21.

Nakai K, Gomi F, Ikuno Y, Yasuno Y, Nouchi T, Ohguro N, Nishida K (2012) Choroidal observations in Vogt-Koyanagi-Harada disease using high-penetration optical coherence tomography. Graefes Arch Clin Exp Ophthalmol 250(7):1089–1095. doi:10.1007/s00417-011-1910-7 CrossRefPubMed

22.

Nakayama M, Keino H, Okada AA, Watanabe T, Taki W, Inoue M, Hirakata A (2012) Enhanced depth imaging optical coherence tomography of the choroid in Vogt-Koyanagi-Harada disease. Retina 32(10):2061–2069. doi:10.1097/IAE.0b013e318256205a CrossRefPubMed

23.

Margolis R, Spaide RF (2009) A pilot study of enhanced depth imaging optical coherence tomography of the choroid in normal eyes. Am J Ophthalmol 147(5):811–815. doi:10.1016/j.ajo.2008.12.008 CrossRefPubMed

24.

Ding X, Li J, Zeng J, Ma W, Liu R, Li T, Yu S, Tang S (2011) Choroidal thickness in healthy Chinese subjects. Invest Ophthalmol Vis Sci 52(13):9555–9560. doi:10.1167/iovs.11-8076 CrossRefPubMed

25.

Lai TY, Chan RP, Chan CK, Lam DS (2009) Effects of the duration of initial oral corticosteroid treatment on the recurrence of inflammation in Vogt-Koyanagi-Harada disease. Eye 23(3):543–548. doi:10.1038/eye.2008.89 CrossRefPubMed

26.

Beck RW, Cleary PA, Trobe JD, Kaufman DI, Kupersmith MJ, Paty DW, Brown CH (1993) The effect of corticosteroids for acute optic neuritis on the subsequent development of multiple sclerosis. The optic neuritis study group. N Engl J Med 329(24):1764–1769. doi:10.1056/nejm199312093292403 CrossRefPubMed

27.

Llao J, Naves JE, Ruiz-Cerulla A, Marin L, Manosa M, Rodriguez-Alonso L, Cabre E, Garcia-Planella E, Guardiola J, Domenech E (2014) Intravenous corticosteroids in moderately active ulcerative colitis refractory to oral corticosteroids. J Crohn’s Colitis 8(11):1523–1528. doi:10.1016/j.crohns.2014.06.010 CrossRef

28.

Chan CC, Paine M, O’Day J (2001) Steroid management in giant cell arteritis. Br J Ophthalmol 85(9):1061–1064CrossRefPubMedPubMedCentral

29.

Czock D, Keller F, Rasche FM, Haussler U (2005) Pharmacokinetics and pharmacodynamics of systemically administered glucocorticoids. Clin Pharmacokinet 44(1):61–98. doi:10.2165/00003088-200544010-00003 CrossRefPubMed

30.

Groenewoud G, Hundt HK, Luus HG, Muller FO, Schall R (1994) Absolute bioavailability of a new high dose methylprednisolone tablet formulation. Int J Clin Pharmacol Ther 32(12):652–654PubMed

31.

Beck RW, Trobe JD (1995) The optic neuritis treatment trial. Putting the results in perspective. The Optic Neuritis Study Group. J Neuroophthalmol 15(3):131–135CrossRefPubMed

32.

Buttgereit F, Scheffold A (2002) Rapid glucocorticoid effects on immune cells. Steroids 67(6):529–534CrossRefPubMed

Title: The effect on choroidal changes of the route of systemic corticosteroids in acute Vogt-Koyanagi-Harada disease
Authors: Un Chul Park
In Hwan Cho
Eun Kyung Lee
Hyeong Gon Yu
Publication date: 01-06-2017
Publisher: Springer Berlin Heidelberg
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 6/2017
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-017-3654-5

ACC 2024 Congress

Springer Medicine

The effect on choroidal changes of the route of systemic corticosteroids in acute Vogt-Koyanagi-Harada disease

Abstract

Purpose

Methods

Results

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 6/2017

Author reply: central corneal thickness determination in corneal edema

The effect of center point shift on the measurement of macular thickness: a spectral domain-optical coherence tomography study

Prevalence and characteristics of pseudodrusen subtypes in advanced age-related macular degeneration

Central corneal thickness determination in corneal edema

Vitamin B12 deficiency evaluation and treatment in severe dry eye disease with neuropathic ocular pain

Ranibizumab versus aflibercept for macular edema due to central retinal vein occlusion: 18-month results in real-life data