Efficacy of azathioprine as a first-line therapy in new onset of acute Vogt-Koyanagi-Harada disease in the Indian population.

PURPOSE

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.