The Effect of Cyelophosphamide Treatment in Vogt-Koyanagi-Harada Disease.

Kwak, Hyung Woo; Kim, Hong Ki; Kim, Sang Min

Original Article

Journal of the Korean Ophthalmological Society 1986;27(5):841-848.
Published online May 1, 1986.

The Effect of Cyelophosphamide Treatment in Vogt-Koyanagi-Harada Disease.

Hyung Woo Kwak, Hong Ki Kim, Sang Min Kim

Department of Ophthalmology, College of Medicine, Kyung Hee University, Korea.

Vogt - Koyanagi - Harada 증후군에서 Cyclophosphamide 의 치료효과

김상민(Sang Min Kim),곽형우(Hyung Woo Kwak),김홍기(Hong Ki Kim)

Abstract

Vogt-Koyanagi-Harada syndrome is a rare disease and is characterized by bilateral uveitis, exudative retinal detachment, dysacousia, alopecia, poliosis and signs of central nervous system involvement including headache and increase in pressure and cellular content of the cerebrospinal fluid. Its cause is unknown, but the findings in patients and the results of previous studies suggest that V-K-H disease is a cell-mediated autoimmune disorder in which a component of myelin acts as an inciting antigen. Recently many investigators have demonstrated the usefullness of cytotoxic metabolic inhibitors in suppressing uveal inflammation except V-K-H disease. And so this study was carried out to evaluate the effect of cyclophosphamide treatment in 4 patients who were resistance to steroids among the patients who were already diagnosed V-K-H disease. Cyclophosphamide was administrated every other day single dose which was 2 mg/kg/day. The results were as follows: 1. The results came out to be that there were loss of intraocular inflammation and increase of visual acuity after cyclophosphamide treatment from 3 months to 6 months and there was no recurrence in follow-up period during about 6 months. 2. The amplitude of scotopic b-wave in patient's electroretinogram during treatment was increased and latency of P1 wave of visual evoked potential was shortened with increase of amplitude of P1 wave, and so the results were showed recovery of retinal damage and optic nerve inflammation. 3. The total dose of cyclophosphamide treatment during treatment from 3 months to 6 months was from 5,600 mg to 12,000 mg, but there was no side effect, that is, decrease of plasma cell count and leukocyte count during treatment and follow-up period.