Prognostic factors for clinical outcomes in patients with Vogt-Koyanagi-Harada disease treated with high-dose corticosteroids

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Purpose:To determine prognostic factors in patients with Vogt-Koyanagi-Harada (VKH) disease who were treated with high-dose corticosteroids.Methods:Analysis of 87 patients (174 eyes).Results:Chronic recurrent presentation was significantly associated with more severe anterior segment inflammation at presentation as indicated by presence of mutton-fat keratic precipitates, anterior chamber reaction of 2+ or more, iris nodules and posterior synechiae, less exudative retinal detachment at presentation, more complications during the follow-up period and a worse visual outcome. The use of immunomodulatory therapy as first line therapy significantly reduced the development of complications in the whole study group and in initial-onset acute group and improved visual outcome in the whole study group. In the whole study group, final visual acuity of 20/20 was significantly associated with good initial visual acuity of >20/200 and age older than 16 years was significantly associated with the development of complications. Conclusions: Chronic recurrent VKH disease is significantly associated with more severe inflammation at presentation and more complications. Use of immunomodulatory therapy improves clinical outcome.

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