Systemic corticosteroid treatment in Vogt-Koyanagi-Harada disease

Twenty patients with Vogt-Koyanagi-Harada disease who had been given systemic corticosteroids were retrospectively analyzed. Sixteen patients were successfully treated with systemic corticosteroids without recurrence of uveitis. Since the advent of corticosteroid treatment, there have been fewer ocular complications as well as extraocular signs and symptoms in most cases. Recurrence of the inflammation, however, occurred in four cases. Drip infusion of 200 mg prednisolone daily, widely employed for the treatment, did not always have good results. It is suggested that the dosage of corticosteroid should be adjusted according to the severity of uveomeningitis. Oral administration of corticosteroid (less than 100 mg prednisolone daily) may be enough for suppression of the inflammation in the Harada type, while a drip infusion of the massive dosage (more than 200 mg prednisolone daily) with gradual tapering off is possibly requisite in the Vogt-Koyanagi type.