Mycophenolate mofetil combined with systemic corticosteroids prevents progression to chronic recurrent inflammation and development of 'sunset glow fundus' in initial-onset acute uveitis associated with Vogt-Koyanagi-Harada disease.
Journal Article
AM, Abu El-Asrar . 2017
Publication Work Type:
Journal Article
Publication Online URL:
Magazine \ Newspaper:
Acta Ophthalmol
Issue Number:
1
Volume Number:
95
Pages:
85-90
Publication Abstract:
ABSTRACT.
Purpose: To evaluate the effectiveness and safety of mycophenolate mofetil
(MMF) as first-line therapy combined with systemic corticosteroids in initialonset
acute uveitis associated with Vogt–Koyanagi–Harada (VKH) disease.
Methods: This prospective study included 38 patients (76 eyes). The main
outcome measures were final visual acuity, corticosteroid-sparing effect,
progression to chronic recurrent granulomatous uveitis and development of
complications, particularly ‘sunset glow fundus’.
Results: The mean follow-up period was 37.0 29.3 (range 9–120 months).
Visual acuity of 20/20 was achieved by 93.4% of the eyes. Corticosteroid-sparing
effect was achieved in all patients. The mean interval between starting treatment and
tapering to 10 mg or less daily was 3.8 1.3 months (range 3–7 months).Twentytwo
patients (57.9%) discontinued treatment without relapse of inflammation. The
mean time observed off of treatment was 28.1 19.6 months (range 1–60 months).
None of the eyes progressed to chronic recurrent granulomatous uveitis. The ocular
complications encountered were glaucoma in two eyes (2.6%) and cataract in five
eyes (6.6%). None of the eyes developed ‘sunset glow fundus’, and none of the
patients developed any systemic adverse events associated with the treatment.
Conclusions: Use of MMF as first-line therapy combined with systemic
corticosteroids in patients with initial-onset acute VKH disease prevents
progression to chronic recurrent granulomatous inflammation and development
of ‘sunset glow fundus’.
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