Earlier immunomodulatory treatment is associated with better visual outcomes in a subset of patients with Vogt-Koyanagi-Harada disease

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dc.contributor.authorUrzua, Cristhian A.
dc.contributor.authorVelasquez, Victor
dc.contributor.authorSabat, Pablo
dc.contributor.authorBerger, Osvaldo
dc.contributor.authorRamirez, Sebastian
dc.contributor.authorGoecke, Annelise
dc.contributor.authorVasquez, Dario H.
dc.contributor.authorGatica, Hector
dc.contributor.authorGuerrero, Julia
dc.date.accessioned2024-01-10T12:38:27Z
dc.date.available2024-01-10T12:38:27Z
dc.date.issued2015
dc.description.abstractPurpose: To evaluate clinical outcomes of first-line immunomodulatory therapy (IMT) and prednisone alone or late IMT in Vogt-Koyanagi-Harada disease.
dc.description.abstractMethods: Retrospective cohort study of 152 patients with Vogt-Koyanagi-Harada disease evaluated in a referral uveitis clinic in Chile from 1985 to 2011. Medical records of these patients were reviewed. Demographic data, clinical evaluation, type of treatment, functional outcomes, glucocorticoid (GC) dose and complications were recorded. Multivariate logistic regression was used to identify prognostic factors of poor response to GC.
dc.description.abstractResults: There were no significant differences between first-line IMT group and prednisone alone/late IMT group in terms of visual acuity (VA) improvement, complications and GC sparing effect. There was a trend for a higher frequency of systemic adverse effects leading to discontinuation of treatment in patients receiving IMT than in those receiving prednisone (14.6% and 6.5%, respectively). The subgroup of patients with poor response to GC who showed functional improvement had a significantly earlier time to IMT initiation than the patients who had no improvement. We identified following prognostic factors of poor response to GC: VA <= 20/200, fundus depigmentation, chronic disease and tinnitus at diagnosis. Patients with a prognostic factor (excluding tinnitus) and VA improvement had an earlier IMT initiation than those who had worse functional outcome.
dc.description.abstractConclusion: There were no differences in outcomes between first-line IMT and prednisone alone/late IMT in the entire VKH group. However, in a subset of patients, there was a significant better functional outcome with earlier IMT initiation.
dc.fechaingreso.objetodigital2024-05-28
dc.format.extent6 páginas
dc.fuente.origenWOS
dc.identifier.doi10.1111/aos.12648
dc.identifier.eissn1755-3768
dc.identifier.issn1755-375X
dc.identifier.pubmedidMEDLINE:25565265
dc.identifier.urihttps://doi.org/10.1111/aos.12648
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/77046
dc.identifier.wosidWOS:000361797700008
dc.information.autorucMedicina;Berger O;S/I;227706
dc.issue.numero6
dc.language.isoen
dc.nota.accesocontenido parcial
dc.publisherWILEY-BLACKWELL
dc.revistaACTA OPHTHALMOLOGICA
dc.rightsacceso restringido
dc.subjectcomplications
dc.subjectfirst-line treatment
dc.subjectfunctional outcomes
dc.subjectglucocorticoids
dc.subjectimmunomodulatory treatment
dc.subjectprognostic factors
dc.subjectVogt-Koyanagi-Harada disease
dc.subjectREVISED DIAGNOSTIC-CRITERIA
dc.subjectCORTICOSTEROID TREATMENT
dc.subjectTHERAPY
dc.subjectAZATHIOPRINE
dc.subjectNOMENCLATURE
dc.subjectDURATION
dc.subjectCOHORT
dc.subjectAGENTS
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleEarlier immunomodulatory treatment is associated with better visual outcomes in a subset of patients with Vogt-Koyanagi-Harada disease
dc.typeartículo
dc.volumen93
sipa.codpersvinculados227706
sipa.indexWOS
sipa.indexScopus
sipa.trazabilidadCarga SIPA;09-01-2024
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