A COVID-19 Risk Reduction Strategy for the Treatment of Acute Vogt-Koyanagi-Harada Disease Utilizing the Antiviral Potential of Cyclosporine.
A COVID-19 Risk Reduction Strategy for the Treatment of Acute Vogt-Koyanagi-Harada Disease Utilizing the Antiviral Potential of Cyclosporine.
复制标题
利用环孢素的抗病毒潜力治疗急性 Vogt-Koyanagi-Harada 病的 COVID-19 风险降低策略。
DOI：
10.1080/09273948.2022.2028293
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Keino H
中科院分区：
文献类型：
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作者：
Nakayama M;Okada AA;Hayashi I;Ando Y;Watanabe T;Keino H
目的报告在 COVID-19 大流行期间利用环孢菌素的抗病毒潜力成功治疗急性 Vogt-Koyanagi-Harada (VKH) 病患者。研究设计案例系列。方法回顾性审查了 4 例新发急性 VKH 病患者的临床记录，他们选择接受初始治疗，包括双侧 Tenon 下注射曲安奈德联合立即开始口服环孢素，而无需服用环孢素。全身性皮质类固醇的使用。结果平均随访时间为 17.0 个月。 3 名患者的双侧最佳矫正视力 (BCVA) 恢复至 1.2，脉络膜厚度降至正常。一名老年患者由于白内障进展和轻度视网膜前膜导致 BCVA 降低（OD 0.5，OS 0.8）。所有患者均未观察到眼内复发。 2 名老年患者出现轻度肾功能障碍，但重要的是没有患者出现 COVID-19 疾病。 结论 口服环孢素作为急性 VKH 病的初始全身治疗，联合 Tenon 下注射曲安奈德，可产生良好的临床结果。由于环孢菌素已知的抗病毒特性，我们认为这可能是 COVID-19 大流行期间患者的良好治疗策略。
PurposeTo report on the successful treatment of patients with acute Vogt-Koyanagi-Harada (VKH) disease utilizing the antiviral potential of cyclosporine during the COVID-19 pandemic.Study DesignCase series.MethodsClinical records were retrospectively reviewed of 4 patients presenting with new-onset acute VKH disease who elected to receive initial treatment consisting of bilateral sub-Tenon injection of triamcinolone acetonide combined with immediately starting oral cyclosporine without the use of systemic corticosteroids.ResultsThe mean follow-up was 17.0 months. Choroidal thickness decreased to normal with recovery of bilateral best-corrected visual acuity (BCVA) of 1.2 in 3 patients. One elderly patient had decreased BCVA (OD 0.5, OS 0.8) due to cataract progression and mild epiretinal membrane. No recurrences of intraocular were observed in any patients. Mild renal dysfunction developed in 2 elderly patients, but importantly no patients developed COVID-19 disease.ConclusionsOral cyclosporine as the initial systemic treatment of acute VKH disease, in combination with sub-Tenon injection of triamcinolone acetonide, lead to favorable clinical outcomes. Due to the known antiviral properties of cyclosporine, we suggest that this may represent a good treatment strategy for patients during the COVID-19 pandemic.