Efficacy of azathioprine as a first-line therapy in new onset of acute Vogt-Koyanagi-Harada disease in the Indian population.

Purpose: The purpose of this study is to evaluate the efficacy of azathioprine as a first-line therapy in new onset of acute Vogt-Koyanagi-Harada (VKH) disease in the Indian population.

Methods: This retrospective study included 17 (34 eyes) patients who received azathioprine along with systemic steroids for new onset of acute VKH disease and had minimum follow-up of 24 months. Uveitis activity was assessed clinically and by indocyanine green angiography.

Results: The mean follow-up period was 27.53 (range: 24-48) months. Corticosteroid-sparing effect was achieved in 14 (82.35%) patients. The median time to achieve the steroid-sparing effect was 3 months (range: 1.5-5 months). Corrected distance visual acuity better than 0.3 logMAR was achieved in 28 (82.35%) eyes. Sunset glow fundus developed in 2 (5.88%) eyes while on azathioprine therapy. None of the eyes developed chronic granulomatous uveitis phase or severe systemic side effect during treatment with azathioprine.

Conclusion: Azathioprine as first-line therapy in patients with new onset of acute VKH disease has effective steroid-sparing effect and prevents progression to chronic recurrent granulomatous stage.