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Vol. 96. Issue 11.
Pages 593-597 (November 2021)
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Vol. 96. Issue 11.
Pages 593-597 (November 2021)
Short communication
Vogt-Koyanagi-Harada: treatment of recurrence after administration of 3 intravenous bolus of 1 g of corticosteroids and mycophenolate mofetil
Vogt-Koyanagi-Harada: tratamiento de la recurrencia tras la administración de 3 bolos intravenosos de 1 g de corticoides y micofenolato de mofetilo
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M. Aguilar-Gonzáleza,
Corresponding author
aguilarmarina.oft@gmail.com

Corresponding author.
, P. Martínez-López-Corella, E. Marín-Payáa, M. Díaz-Llopisb, R. Gallego-Pinazoc, M. Andreu-Fenolla
a Department of Ophthalmology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
b Departamento de Retina Médica, Hospital Universitari i Politècnic La Fe, Valencia, Spain
c Departamento de Retina Médica, Clínica Oftalvist, Valencia, Spain
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Abstract

The case is presented on a young Honduran female with no medical history of note, who presented with multiple areas of exudative retinal detachment (RD), and a best-corrected visual acuity of 1.3 logMAR in both eyes. She was diagnosed with incomplete Vogt-Koyanagi-Harada syndrome, and treated early with a combination of intravenous therapy with 1 g of prednisolone per day for 3 days, as recommended by published evidence, as well as mycophenolate mofetil (2 g per day). During the corticosteroids tapering, there was a recurrence of exudative retinal detachments, and megadoses of 1 g of intravenous corticosteroids per day were reintroduced for 6 days until the complete resolution of the fluid of the exudative RD, and cyclosporine (100 mg per day), subtenon triamcinolone (40 mg/mL), and intravitreal ranibizumab once a month in the both eyes were added to the treatment, with a great control of choroidal inflammation that resulted in the remission of symptoms and signs.

Keywords:
Vogt-Koyanagi-Harada
Recurrence
Medical treatment
Resumen

Presentamos el caso de una mujer hondureña de 27 años sin antecedentes médicos de interés que presentó múltiples áreas de desprendimientos de retina (DR) exudativos y una una mejor agudeza visual corregida (MAVC) de 1.3 logMAR en ambos ojos (AO). Fue diagnosticada de Síndrome de Vogt-Koyanagi-Harada (VKH) incompleto y tratada con prednisolona intravenosa (1 g / 24 horas) durante 3 días, tal y como recomienda la evidencia publicada, junto con micofenolato de mofetilo (MMF) (2 g / 24 horas). Durante el descenso paulatino de corticoesteroides, los DR recidivaron, por lo que se reintrodujeron las megadosis de 1 g / 24 horas de corticoesteorides intravenosos durante 6 días hasta la resolución completa de los DR y se añadiron ciclosporina (100 mg / 24 horas), triamcinonolona subtenoniana (40 mg/mL) e inyecciones intravítreas mensuales de ranibizumab en AO, con un adecuado control de la inflamación coroidea que se tradujo en la remisión de los síntomas y signos.

Palabras clave:
Vogt-Koyanagi-Harada
Recurrencia
Tratamiento médico

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