BMC ophthalmology
Short-term outcomes associated with oral prednisolone versus posterior sub-Tenon triamcinolone acetonide in acute ocular Vogt-Koyanagi-Harada disease
By Saad EME, Abouelela MI and Elsayed MA.
Abstract
Purpose
To describe short-term clinical and anatomical outcomes associated with oral prednisolone and posterior sub-Tenon triamcinolone acetonide as initial corticosteroid-based treatment strategies in acute ocular Vogt-Koyanagi-Harada Disease (VKH).
Methods
This retrospective comparative cohort study included 30 treatment-naïve patients (60 eyes) with acute ocular VKH treated at a tertiary referral center between January 2021 and December 2025. Patients were classified using a study-specific two-tier designation (definite or probable VKH) derived from the 2001 Revised Diagnostic Criteria. Treatment assignment (oral prednisolone, n = 15, 1.0 mg/kg/day tapered over 3-6 weeks; or PST/STA, n = 15) was guided by clinical severity and systemic involvement. The primary outcome was complete clinical and anatomical ocular control at 3 months, defined as absence of clinically active intraocular inflammation, resolution of subretinal fluid on OCT, and stable or improved BCVA. Secondary outcomes included BCVA over 6 months, OCT-based anatomical recovery, recurrence rates, rescue therapy requirement, and adverse events. Resolution of subretinal fluid was assessed qualitatively on OCT as complete disappearance of the subretinal fluid pocket, with central macular thickness (CMT) recorded in parallel as a supportive structural measure. Statistical analyses included the independent and paired t-tests, two-sided Fisher's exact test, and Kaplan-Meier analysis with the log-rank test.