Corticosteroid Therapy in the Initial Cases of Vogt-Koyanagi-Harada Disease

  Objective  To observe the application and effectiveness of corticosteroid therapy for the initial cases of Vogt-Koyanagi-Harada disease (VKH).

  Methods  Totally 21 VKH cases (42 eyes) from January 2008 to January 2012 in our hospital with initial onset and duration within a week were administered with prednisone of 120-140 mg/d at early morning. The dosage was reduced 20 mg every 3 to 5 days based on the condition improved and reduced 10 mg every 5 days when the dosage reached 80 mg/d, then reduced 5 mg every week from 60 mg/d. When the dose reduced to 15 mg/d, it was maintained for 1-2 months. After that the dose should be gradually reduced by 5 mg per week until zero.

  Results  One day after treatment, headache disappeared and visual acuity improved in all patients. On the third day, the visual acuity improved significantly and retinal detachment improved remarkably. On the seventh day, there were 36 eyes (85.7%) with visual acuity ≥ 0.5 and retinal detachments disappeared in all eyes. One month later, the visual acuity returned the optimal levels before the onset in all patients. No serious corticosteroid complications occurred during the treatment. During the 12to 36month follow-up, no recurrence was noted.

  Conclusion  Initial treatment with high-dose corticosteroids followed by prolonged corticosteroid therapy can effectively control the VKH.