View abstract

This abstract is assigned to session Free Papers - Oral Presentations III

Presentation preference	Oral presentation
Title	Clinical outcomes in acute Vogt-Koyanagi-Harada patients during a 24-month follow-up
Accept poster if oral is not possible ?	Yes

Purpose	To retrospectively evaluate the clinical outcomes of VKHD patients (pt) followed for 24 months (mo) since acute disease onset based on timing of corticosteroid (CS) treatment, associated or not with immunosuppressive therapy (IMT).
Methods	All 35 acute VKHD pt (32F, median age 32 years) included were treated with 3 pulses of intravenous methylprednisolone (1000 mg/day) followed by oral prednisone (1mg/kg/day) with slow taper. CS within 30 days from disease onset defined the early group (n=24 pt): 9 pt with CS only (group 1) and 15 pt with oral IMT within 3 mo from diagnosis (group 2). Those pt with CS after 30 days defined the late group (group 3) (n=11 pt), all with late IMT. Anterior uveitis (AU) recurrence, multimodal image analysis (baseline, M1, M2, M4, M6, than every 3 mo), best-corrected visual acuity (BCVA) and full-field electroretinogram parameters were analyzed.
Results	Median BCVA was logMAR 0 (0-0.4) (p=0.674) at M24, with similar inflammation control (cells in anterior chamber, p=0.542; serous retinal detachment, p=0.741) among the groups. But, group 3 had higher fluorescein angiography total score (p=0.012), more BCVA fluctuation episodes (p=0.004), more AU recurrence (p=0.018) and more sunset glow fundus (p=0.042), fibrosis (p=0.02) and peripapillary atrophy (p=0.003). Groups 1 and 2 had comparable response to therapy in acute disease and also during the 24-mo follow-up. However, group 2 reached prednisone < 10mg/day earlier (p=0.043) and had a lower total prednisone cumulative dose (p=0.015).
Conclusion	Late CS group had worse outcomes emphasizing the importance of early high-dose CS. Association of early IMT had a significant CS sparing effect but comparable response to therapy
Conflict of interest	No

1

Last name	SILVEIRA SOUTO
Initials of first name(s)	FM
Department	Department of Ophthalmology, Universidade de São Paulo, Faculdade de Medicina, LIM 33
City	Sao Paulo
Country	Brazil

2

Last name	LAVEZZO
Initials of first name(s)	M M
Department	Department of Ophthalmology, Universidade de São Paulo, Faculdade de Medicina, LIM 33
City	Sao Paulo
Country	Brazil

3

Last name	BRITO GONCALVES MISSAKA
Initials of first name(s)	R F
Department	Department of Ophthalmology, Universidade de São Paulo, Faculdade de Medicina, LIM 33
City	Sao Paulo
Country	Brazil

4

Last name	CAMPOS DA NOBREGA
Initials of first name(s)	P F
Department	Department of Ophthalmology, Universidade de São Paulo, Faculdade de Medicina, LIM 33
City	Sao Paulo
Country	Brazil

5

Last name	GUSMÃO
Initials of first name(s)	C C
Department	Department of Ophthalmology, Universidade de São Paulo, Faculdade de Medicina, LIM 33
City	Sao Paulo
Country	Brazil

6

Last name	SAKATA
Initials of first name(s)	V M
Department	Department of Ophthalmology, Universidade de São Paulo, Faculdade de Medicina, LIM 33
City	Sao Paulo
Country	Brazil

7

Last name	CUNNINGHAM JR
Initials of first name(s)	E T
Department	West Coast Medical Group, California Pacifical Medical Center, Stanford University, UCSF
City	San Francisco
Country	United States

8

Last name	OYAMADA
Initials of first name(s)	M K
Department	Department of Ophthalmology, Universidade de São Paulo, Faculdade de Medicina, LIM 33
City	Sao Paulo
Country	Brazil

9

Last name	HIRATA
Initials of first name(s)	C E
Department	Department of Ophthalmology, Universidade de São Paulo, Faculdade de Medicina, LIM 33
City	Sao Paulo
Country	Brazil

10

Last name	YAMAMOTO
Initials of first name(s)	J H
Department	Department of Ophthalmology, Universidade de São Paulo, Faculdade de Medicina, LIM 33
City	Sao Paulo
Country	Brazil