Parchand Swapnil M, Saraogi Tripti, Chatterjee Samrat, Gangwe Anil, Agrawal Deepanshu, Agrawal Deepshikha
Department of Uvea Services, MGM Eye Institute, Raipur, Chhattisgarh, India.
Saudi J Ophthalmol. 2025 Feb 21;39(1):65-70. doi: 10.4103/sjopt.sjopt_200_23. eCollection 2025 Jan-Mar.
The purpose of this study is to evaluate the efficacy of azathioprine as a first-line therapy in new onset of acute Vogt-Koyanagi-Harada (VKH) disease in the Indian population.
This retrospective study included 17 (34 eyes) patients who received azathioprine along with systemic steroids for new onset of acute VKH disease and had minimum follow-up of 24 months. Uveitis activity was assessed clinically and by indocyanine green angiography.
The mean follow-up period was 27.53 (range: 24-48) months. Corticosteroid-sparing effect was achieved in 14 (82.35%) patients. The median time to achieve the steroid-sparing effect was 3 months (range: 1.5-5 months). Corrected distance visual acuity better than 0.3 logMAR was achieved in 28 (82.35%) eyes. Sunset glow fundus developed in 2 (5.88%) eyes while on azathioprine therapy. None of the eyes developed chronic granulomatous uveitis phase or severe systemic side effect during treatment with azathioprine.
Azathioprine as first-line therapy in patients with new onset of acute VKH disease has effective steroid-sparing effect and prevents progression to chronic recurrent granulomatous stage.
本研究旨在评估硫唑嘌呤作为印度人群急性Vogt-小柳原田（VKH）病初发时一线治疗方法的疗效。
这项回顾性研究纳入了17例（34只眼）急性VKH病初发时接受硫唑嘌呤联合全身用类固醇治疗且随访时间至少24个月的患者。通过临床检查和吲哚菁绿血管造影评估葡萄膜炎活动情况。
平均随访时间为27.53（范围：24 - 48）个月。14例（82.35%）患者实现了类固醇节省效应。实现类固醇节省效应的中位时间为3个月（范围：1.5 - 5个月）。28只眼（82.35%）的矫正远视力优于0.3 logMAR。在接受硫唑嘌呤治疗期间，2只眼（5.88%）出现晚霞样眼底。在硫唑嘌呤治疗期间，没有一只眼发展为慢性肉芽肿性葡萄膜炎阶段或出现严重的全身副作用。
硫唑嘌呤作为急性VKH病初发患者的一线治疗方法具有有效的类固醇节省效应，并可防止病情进展至慢性复发性肉芽肿阶段。
