Título / Title

FULL-FIELD ELECTRORETINOGRAM BEHAVIOR IN VOGT-KOYANAGI-HARADA DISEASE: A 24-MONTH LONGITUDINAL STUDY IN PATIENTS FROM ACUTE ONSET EVALUATED WITH MULTIMODAL ANALYSIS

Introdução / Purpose

To prospectively evaluate the dynamic changes of full-field electroretinogram (ff-ERG) and its association with inflammatory signs in patients with acute Vogt-Koyanagi-Harada disease (VKHD).

Material e Método / Methods

Twelve acute VKHD patients, followed up for 24 months, were enrolled from June 2011 to January 2017 at a tertiary center. Treatment consists of intravenous methylprednisolone followed by 1mg/kg/day of oral prednisone with a slow taper, associated or not with late non-steroidal immunosuppressive therapy. Inflammation was systematically evaluated by clinical and posterior segment imaging (PSI) exams (fluorescein FA and indocyanine green angiographies ICGA, enhanced depth imaging optical coherence tomography EDI-OCT). ff-ERG was performed upon enrollment and at predefined intervals. Scotopic ff-ERG parameters changes between 12th and 24th month defined ERG-stable or ERG-worsening groups. “Flare” was defined as any appearance or worsening of inflammatory signs, after the initial six months from disease onset, during the predefined treatment protocol.

Resultados / Results

ff-ERG parameters had an initial improvement in all eyes; in the evaluation between 12th and 24th month, ff-ERG results were stable in 17 eyes (71%) and worsened in 7 eyes (29%). Subnormal ff-ERG results were observed in 18 eyes (75%) at 24th month. On the other hand, flare was observed in 8 eyes (33%) as cells in anterior chamber and in 24 eyes (100%) as any PSI inflammatory sign. No significant association was detected between ff-ERG groups and clinical and treatment data.

Discussão e Conclusões / Conclusion

Scotopic ff-ERG parameters worsened during 12th to 24th evaluation in a quarter of our patients. At this point, no clear association with inflammatory signs was found.

Palavras Chave

Vogt-Koyanagi-Harada, subclinical inflammation, indocyanine green angiography, electroretinogram, corticosteroid