Clinical Rheumatology

, Volume 34, Issue 6, pp 1145–1148 | Cite as

Bilateral dexamethasone intravitreal implant in a young patient with Vogt-Koyanagi-Harada disease and refractory uveitis

  • Maria Eugenia Latronico
  • Donato Rigante
  • Francesco Caso
  • Luca CantariniEmail author
  • Luisa Costa
  • Laura Nieves-Martín
  • Claudio Traversi
  • Rossella Franceschini
Case Based Review


Vogt-Koyanagi-Harada disease (VKHD) is a multisystemic disorder characterized by granulomatous panuveitis with exudative retinal detachments, often associated with neurologic and cutaneous manifestations. Therapy relies mainly on the use of corticosteroids, administrated as oral or intravenous high-dose pulses, and immunosuppressants. However, since macular edema and retinal detachment can often be refractory to systemic therapies, intravitreal triamcinolone acetate has been used successfully. Herein, we report the first case of refractory bilateral panuveitis in a young patient with VKHD successfully treated with dexamethasone intravitreal implant.


Prednisone Therapy Uveitis Vogt-Koyanagi-Harada disease (VKHD) 





  1. 1.
    Tagawa Y, Sugiura S, Yakura H, Wakisaka A, Aizawa M (1976) HLA and Vogt-Koyanagi-Harada syndrome. N Engl J Med 295:173PubMedGoogle Scholar
  2. 2.
    Greco A, Fusconi M, Gallo A, Turchetta R, Marinelli C, Macri GF, De Virgilio A, de Vincentiis M (2013) Vogt-Koyanagi-Harada syndrome. Autoimmun Rev 12:1033–1038CrossRefPubMedGoogle Scholar
  3. 3.
    Yamanaka E, Ohguro N, Yamamoto S, Nakagawa Y, Imoto Y, Tano Y (2002) Evaluation of pulse corticosteroid therapy for Vogt-Koyanagi-Harada disease assessed by optical coherence tomography. Am J Ophthalmol 134:454–456CrossRefPubMedGoogle Scholar
  4. 4.
    Andrade RE, Muccioli C, Farah ME, Nussenblatt RB, Belfort R Jr (2004) Intravitreal triamcinolone in the treatment of serous retinal detachment in Vogt-Koyanagi-Harada syndrome. Am J Ophthalmol 137:572–574CrossRefPubMedGoogle Scholar
  5. 5.
    Haller JA, Bandello F, Belfort R Jr, Blumenkranz MS, Gillies M, Heier J, Loewenstein A, Yoon YH, Jacques ML, Jiao J, Li XY, Whitcup SM, OZURDEX GENEVA Study Group (2010) Randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with macular edema due to retinal vein occlusion. Ophthalmology 117:1134–1146(e3)CrossRefPubMedGoogle Scholar
  6. 6.
    Kuppermann BD, Blumenkranz MS, Haller JA, Williams GA, Weinberg DV, Chou C, Whitcup SM, Dexamethasone DDS Phase II Study Group (2007) Randomized controlled study of an intravitreous dexamethasone drug delivery system in patients with persistent macular edema. Arch Ophthalmol 125:309–317CrossRefPubMedGoogle Scholar
  7. 7.
    Chuang CT, Huang PS, Chen SC, Sheu SJ (2013) Reversible alopecia in Vogt-Koyanagi-Harada disease and sympathetic ophthalmia. J Ophthalmic Inflamm Infect 3:41CrossRefPubMedCentralPubMedGoogle Scholar
  8. 8.
    Myung JS, Aaker GD, Kiss S (2010) Treatment of noninfectious posterior uveitis with dexamethasone intravitreal implant. Clin Ophthalmol 4:1423–1426PubMedCentralPubMedGoogle Scholar
  9. 9.
    Sfriso P, Caso F, Tognon S, Galozzi P, Gava A, Punzi L (2012) Blau syndrome, clinical and genetic aspects. Autoimmun Rev 12:44–51CrossRefPubMedGoogle Scholar
  10. 10.
    Caso F, Wouters CH, Rose CD, Costa L, Tognon S, Sfriso P, Cantarini L, Rigante D, Punzi L (2014) Blau syndrome and latent tubercular infection: an unresolved partnership. Int J Rheum Dis. doi: 10.1111/1756-185X.12330 Google Scholar

Copyright information

© Clinical Rheumatology 2014

Authors and Affiliations

  • Maria Eugenia Latronico
    • 1
  • Donato Rigante
    • 2
  • Francesco Caso
    • 3
    • 4
  • Luca Cantarini
    • 3
    Email author
  • Luisa Costa
    • 5
  • Laura Nieves-Martín
    • 3
    • 6
  • Claudio Traversi
    • 1
  • Rossella Franceschini
    • 1
  1. 1.Ophthalmology and Neurosurgery DepartmentUniversity of SienaSienaItaly
  2. 2.Institute of PediatricsUniversità Cattolica Sacro CuoreRomeItaly
  3. 3.Research Center of Systemic Autoimmune and Autoinflammatory Diseases, Rheumatology Unit, Policlinico Le ScotteUniversity of SienaSienaItaly
  4. 4.Rheumatology Unit, Department of Medicine DIMEDUniversity of PaduaPaduaItaly
  5. 5.Rheumatology Unit, Department of Clinical Medicine and SurgeryUniversity Federico IINaplesItaly
  6. 6.Rheumatology Service, Hospital Regional Universitario Carlos HayaUniversity of MálagaMálagaSpain

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