Regarding Kaya P et al. “Predictive Factors for the Prognosis of Vogt-Koyanagi-Harada Disease”

ABSTRACT

Introduction

VKH is a primary stromal choroiditis. Studies with indocyanine green angiography (ICGA) have shown that inflammation begins at the choroid and may persist without clinically apparent inflammation. Thus, systemic therapy must target choroidal inflammation and be maintained until the choroiditis resolves, as proven by ICG and/or EDI-OCT imaging studies.

Discussion

Aggressive therapy with oral corticosteroids, with or without “pulsed” intravenous methylprednisolone, has been the mainstay of VKH therapy in the acute phase for many years. However, there is convincing evidence that corticosteroid monotherapy is insufficient to prevent progression onto the chronic recurrent form of the disease, which is associated with poor visual outcomes.

Conclusion

Numerous studies suggest that combined therapy with systemic corticosteroids and immunosuppressants is necessary to prevent the progression toward chronic recurrent disease, avoiding complications, get a better control of inflammation and visual outcomes in VKH patients seen at the uveitic phase of the disease.

KEYWORDS:

• Chronic inflammation
• immunosuppressive agents
• panuveitis
• systemic corticosteroids
• Vogt-Koyanagi-Harada

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Partially funded by the Immuneye Foundation of Monterrey.