Changes in ocular biomarkers in Vogt-Koyanagi-Harada disease after pulse steroid therapy
Reviewed by Sofia Rokerya

This retrospective study aimed to evaluate the early and chronological changes in ocular biomarkers in patients of Vogt Koyanagi Harada (VKH) disease who received pulse steroid therapy. It further aimed to identify which biomarkers correlated with the best corrected visual acuity (BCVA) at month one and month six. The study cohort comprised of 33 patients (66 eyes) with VKH (mean age ±standard deviation (SD), 41.8 ±14.7; range, 13–77 years) who received pulse steroid therapy. The central anterior-chamber depth (ACD) and peripheral ACD, axial length, BCVA, spherical equivalent (SE), choroidal foveal thickness (CFT), and retinal foveal thickness (RFT) were evaluated and analysed. Patients were divided into two groups based on BCVA at months one and six, and the correlations with ocular biomarkers were investigated. The results indicated that RFT and CFT were significantly reduced as early as day one (p<0.001). Taken together, retinal and choroidal thicknesses are the earliest parameters for determining therapeutic effect, with subsequent functional improvement and refractive changes. Changes in anterior chamber appeared to be slow and delayed. Axial length gradually increased, with a significant increase observed at month one (p<0.05). BCVA improved significantly along with SE reduction, with significant changes observed at week one (p<0.05 and p<0.01, respectively). Anterior-chamber biomarkers gradually increased, with significant increases at week two for central ACD (p<0.05) and at month one for peripheral ACD (p<0.05). The better BCVA group at month one significantly correlated with thicker RFT (p<0.01), better BCVA (p<0.05), shallower central ACD (p<0.05), and shallower peripheral ACD (p<0.05) at the initial visit. No correlation was observed between the better BCVA group at month six and ocular biomarkers at the initial visit. The study concluded that RFT and CFT changes are the earliest indicators, and changes in the anterior-chamber structure appeared to be slow and delayed. Thicker RFT, better BCVA, shallower central ACD, and shallower peripheral ACD at the initial visit correlated with better BCVA at one month. Limitations: Retrospective design. Due to uniform starting dose of corticosteroids there may have been potential undertreatment of patients above 80kg weight.

Early changes in ocular biomarkers in patients with Vogt-Koyanagi-Harada disease after pulse steroid therapy.
Muto T, Kawaguchia S, Kusuda S, et al.
OPHTHALMOLOGICA
2025;248:40–53.