Cyclosporin therapy in Vogt Koyanagi Harada disease

Vogt Koyanagi Harada Disease (VKHD) is a rare cause of uveitis and has not been previously reported in the Australian literature. The natural history of this severe inflammatory eye disease may be modified by the early use of high-dose immunosuppressive therapy, especially oral corticosteroids. We report three cases of VKHD who either failed to respond to high-dose corticosteroid (oral and intravenous) therapy alone or developed significant side effects, one of whom subsequently showed a beneficial response and another a transient beneficial response to cyclosporin therapy. Disease relapse or exacerbation of uveitis was the major problem encountered on attempted cyclosporin withdrawal. Further research is needed to define the optimum timing and indications for cyclosporin therapy in patients with VKHD.