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May 1991

Vogt-Koyanagi-Harada Syndrome: Clinical Course, Therapy, and Long-term Visual Outcome

Author Affiliations

From the Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami (Fla) School of Medicine.

Arch Ophthalmol. 1991;109(5):682-687. doi:10.1001/archopht.1991.01080050096037

• We reviewed data from 26 patients with Vogt-Koyanagi-Harada syndrome who presented at the Bascom Palmer Eye Institute between March 1969 and February 1990. Visual outcomes were good, with final visual acuity of better than 20/30 in 29 (66%) of 44 eyes and of worse than 20/400 in only three (7%) of 44 eyes. A poor prognosis was associated with the development of choroidal neovascular membranes or chronic uveitis. All patients were treated with systemic corticosteroids. Corticosteroid therapy averaged 6 months, but was prolonged (48 months) in patients who developed chronic uveitis. Disease recurred in nine (43%) of 21patients in the first 3 months, usually in association with a rapid tapering of steroid dosage. We recommend the early, aggressive use of systemic corticosteroids in patients with Vogt-Koyanagi-Harada syndrome and a gradual tapering of drug dosage for 6 months after presentation.

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