医学
养生
强的松
伏格特-小柳-原田病
免疫抑制
内科学
外科
疾病
作者
Kaixuan Wang,Chuanzhen Zheng,Guixia Zhao,Mi Zhang,Tong Liu,Huan Li,Qingqin Tao,Zhaohui Cheng,Xiaorong Li,Xiao Min Zhang
出处
期刊:Retina-the Journal of Retinal and Vitreous Diseases
[Ovid Technologies (Wolters Kluwer)]
日期:2023-09-01
卷期号:43 (9): 1496-1505
标识
DOI:10.1097/iae.0000000000003837
摘要
To report the clinical profile and outcomes of acute Vogt-Koyanagi-Harada disease with a strict immunosuppression regimen and investigate the risk factors for a prolonged disease course.A total of 101 patients with acute Vogt-Koyanagi-Harada (202 eyes) with more than 24 months of follow-up were recruited from January 2011 to June 2020. They were divided into two groups according to the interval between the onset of Vogt-Koyanagi-Harada and treatment. Oral prednisone was gradually tapered off by a diminished dose according to a relatively strict protocol. Patient responses to the treatment regimen were classified as long-term drug-free remission or chronic recurrent.Ninety-six patients (95.0%) achieved long-term drug-free remission without recurrence, while 5 (5.0%) had chronic recurrence. Most patients achieved good best-corrected visual acuity (90.6% ≧20/25). A generalized estimation equation model demonstrated that time of visit, ocular complications, and cigarette smoking were independent risk factors for a longer disease course, and smokers required a higher drug dose and longer treatment course than nonsmokers.An immunosuppressive regimen with an appropriate tapering speed can lead to long-term drug-free remission in patients with acute Vogt-Koyanagi-Harada. Cigarette smoking significantly affects ocular inflammation.
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