{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T09:14:27Z","timestamp":1793610867754,"version":"4.5.0"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,1,7]],"date-time":"2015-01-07T00:00:00Z","timestamp":1420588800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To evaluate clinical outcomes of first\u2010line immunomodulatory therapy (<jats:styled-content style=\"fixed-case\">IMT<\/jats:styled-content>) and prednisone alone or late <jats:styled-content style=\"fixed-case\">IMT<\/jats:styled-content> in <jats:styled-content style=\"fixed-case\">V<\/jats:styled-content>ogt\u2010<jats:styled-content style=\"fixed-case\">K<\/jats:styled-content>oyanagi\u2010<jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>arada disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective cohort study of 152 patients with <jats:styled-content style=\"fixed-case\">V<\/jats:styled-content>ogt\u2010<jats:styled-content style=\"fixed-case\">K<\/jats:styled-content>oyanagi\u2010<jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>arada disease evaluated in a referral uveitis clinic in <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>hile from 1985 to 2011. Medical records of these patients were reviewed. Demographic data, clinical evaluation, type of treatment, functional outcomes, glucocorticoid (<jats:styled-content style=\"fixed-case\">GC<\/jats:styled-content>) dose and complications were recorded. Multivariate logistic regression was used to identify prognostic factors of poor response to <jats:styled-content style=\"fixed-case\">GC<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were no significant differences between first\u2010line <jats:styled-content style=\"fixed-case\">IMT<\/jats:styled-content> group and prednisone alone\/late <jats:styled-content style=\"fixed-case\">IMT<\/jats:styled-content> group in terms of visual acuity (<jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content>) improvement, complications and <jats:styled-content style=\"fixed-case\">GC<\/jats:styled-content> sparing effect. There was a trend for a higher frequency of systemic adverse effects leading to discontinuation of treatment in patients receiving <jats:styled-content style=\"fixed-case\">IMT<\/jats:styled-content> than in those receiving prednisone (14.6% and 6.5%, respectively). The subgroup of patients with poor response to <jats:styled-content style=\"fixed-case\">GC<\/jats:styled-content> who showed functional improvement had a significantly earlier time to <jats:styled-content style=\"fixed-case\">IMT<\/jats:styled-content> initiation than the patients who had no improvement. We identified following prognostic factors of poor response to <jats:styled-content style=\"fixed-case\">GC<\/jats:styled-content>:<jats:styled-content style=\"fixed-case\"> VA<\/jats:styled-content> \u226420\/200, fundus depigmentation, chronic disease and tinnitus at diagnosis. Patients with a prognostic factor (excluding tinnitus) and <jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content> improvement had an earlier <jats:styled-content style=\"fixed-case\">IMT<\/jats:styled-content> initiation than those who had worse functional outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There were no differences in outcomes between first\u2010line <jats:styled-content style=\"fixed-case\">IMT<\/jats:styled-content> and prednisone alone\/late <jats:styled-content style=\"fixed-case\">IMT<\/jats:styled-content> in the entire <jats:styled-content style=\"fixed-case\">VKH<\/jats:styled-content> group. However, in a subset of patients, there was a significant better functional outcome with earlier <jats:styled-content style=\"fixed-case\">IMT<\/jats:styled-content> initiation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.12648","type":"journal-article","created":{"date-parts":[[2015,1,7]],"date-time":"2015-01-07T07:32:06Z","timestamp":1420615926000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Earlier immunomodulatory treatment is associated with better visual outcomes in a subset of patients with <scp>V<\/scp>ogt\u2010<scp>K<\/scp>oyanagi\u2010<scp>H<\/scp>arada disease"],"prefix":"10.1111","volume":"93","author":[{"given":"Cristhian A.","family":"Urzua","sequence":"first","affiliation":[{"name":"Uveitis Department Salvador's Hospital Santiago Chile"},{"name":"Ophthalmology Department University of Chile Santiago Chile"},{"name":"Physiology Program Faculty of Medicine University of Chile Santiago 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