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Vogt-Koyanagi-Harada disease: parameters for effective treatment in the acute phase and in long-standing disease

Grant number: 11/50936-7
Support type:Regular Research Grants
Duration: October 01, 2012 - March 31, 2015
Field of knowledge:Health Sciences - Medicine - Medical Clinics
Principal researcher:Joyce Hisae Yamamoto Takiuti
Grantee:Joyce Hisae Yamamoto Takiuti
Home Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil

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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Scientific publications (5)
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
LAVEZZO, MARCELO MENDES; SAKATA, VIVIANE MAYUMI; MORITA, CELSO; CASO RODRIGUEZ, EVER ERNESTO; ABDALLAH, SMAIRAH FRUTUOSO; DA SILVA, FELIPE T. G.; HIRATA, CARLOS EDUARDO; YAMAMOTO, JOYCE HISAE. Vogt-Koyanagi-Harada disease: review of a rare autoimmune disease targeting antigens of melanocytes. ORPHANET JOURNAL OF RARE DISEASES, v. 11, . (11/50936-7, 11/19194-4)
SOUTO, FERNANDA MARIA SILVEIRA; MISSAKA, RUY FELIPPE BRITO GONCALVES; LAVEZZO, MARCELO MENDES; MAYUMI SAKATA, VIVIANE; OYAMADA, MARIA KIYOKO; HIRATA, CARLOS EDUARDO; YAMAMOTO, JOYCE HISAE. Associations between functional and structural measurements in non-acute Vogt-Koyanagi-Harada disease. ACTA OPHTHALMOLOGICA, v. 99, n. 5, p. E715-E723, . (11/50936-7)
BRITO GONCALVES MISSAKA, RUY FELIPPE; GOLDBAUM, MAURO; MACHADO, CLEIDE GUIMARAES; CUNNINGHAM JR, EMMETT T.; SILVEIRA SOUTO, FERNANDA MARIA; LAVEZZO, MARCELO MENDES; CAMPOS DA NOBREGA, PRISCILLA FIGUEIREDO; SAKATA, VIVIANE MAYUMI; OYAMADA, MARIA KIYOKO; HIRATA, CARLOS EDUARDO; et al. Fingerprint sign in Vogt-Koyanagi-Harada disease: a case series. INTERNATIONAL JOURNAL OF RETINA AND VITREOUS, v. 8, n. 1, . (11/50936-7)
SAKATA, VIVIANE M.; DA SILVA, FELIPE T.; HIRATA, CARLOS E.; MARIN, MARIA LUCIA C.; RODRIGUES, HELCIO; KALIL, JORGE; COSTA, ROGERIO A.; YAMAMOTO, JOYCE H.. High rate of clinical recurrence in patients with Vogt-Koyanagi-Harada disease treated with early high-dose corticosteroids. GRAEFES' ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY, v. 253, n. 5, p. 785-790, . (11/50936-7)
SILVEIRA SOUTO, FERNANDA MARIA; BRITO GONCALVES MISSAKA, RUY FELIPPE; MAGALHAES, BRENO MARCHIORI; COUTO CAETANO, VICTOR MARCOS; TAKIUTI, JULIA THIEMI; LAVEZZO, MARCELO MENDES; SAKATA, VIVIANE MAYUMI; OYAMADA, MARIA KIYOKO; HIRATA, CARLOS EDUARDO; YAMAMOTO, JOYCE HISAE. Impact of Inflammation and Treatment on Self-reported Quality of Life in Patients with Non-acute Vogt-Koyanagi-Harada Disease (VKHD). OCULAR IMMUNOLOGY AND INFLAMMATION, v. 29, n. 1, . (11/50936-7)

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