| Grant number: | 11/50936-7 |
| Support Opportunities: | Regular Research Grants |
| Start date: | October 01, 2012 |
| End date: | March 31, 2015 |
| Field of knowledge: | Health Sciences - Medicine - Medical Clinics |
| Principal Investigator: | Joyce Hisae Yamamoto Takiuti |
| Grantee: | Joyce Hisae Yamamoto Takiuti |
| Host Institution: | Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil |
| City of the host institution: | São Paulo |
Abstract
Vogt-Koyanagi-Harada (VKH) disease is an autoimmune disease that targets melanocyte related proteins of genetically susceptible individuals. Its clinical course is subdivided into four phases: prodromal (flu-like symptoms), uveitis, convalescent and chronic. Pigmentary alterations of the choroid and skin may be observed in the course of either convalescent and/or chronic phases. Some authors have drawn attention to the progression of these alterations in cases with little or none overt inflammation and have correlated this phenomenon with disease severity. Da Silva et al. conducted a study (supported by FAPESP grant 07/57.155-5 and scholarship 07/57.154-9) in which subclinical choroidal activity was detected using indocyanine green angiography (ICGA) in 80 % of cases in the late-stage of the disease (defined as >6 months from disease onset). Thus, the present study aims to: 1. Propose more aggressive treatment for patients with combined clinicai and subclinical (ICGA) disease activity while observing those with either isolated clinical or subclinical disease activity, as well as those with neither. 2. Implement more aggressive treatment regimens for acute phase patients and compare outcomes of this group with those obtained in a retrospective manner by da Silva et al. Outcome measures will include best corrected visual acuity (in logMAR scale), clinical disease activity, retinal morphology (retinography, fluorescein angiography, ICGA and spectral domain optical coherence tomography), and function (full-field and multifocal electroretinogram). Patients will be followed up for a minimum of 12 months (acute phase) or 18 months (late-stage) at pre-defined time intervals. Upon completion of this investigation, a better understanding of the impact more aggressive treatment regimens may have on the morphological and functional derrangements that occur in VKH disease in both acute phase and late-stage will be established. (AU)
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