Treatment of Pediatric Vogt-Koyanagi-Harada Syndrome with Infliximab

Purpose: To report treatment results with infliximab in 2 pediatric Vogt-Koyanagi-Harada syndrome (VKH) patients. Design: Interventional case series. Methods: Medical records of 2 patients were reviewed. Results: In 1 case with bilateral complete serous detachments, there was improvement but persistent fluid after 2 months of high-dose prednisone, methotrexate, and infliximab therapy. Infliximab was discontinued, and cyclophosphamide monthly intravenous injections were initiated with resolution of all subretinal fluid within 3 weeks. The second patient had mild subretinal fluid around the right optic nerve head tracking into the macula. Treatment with prednisone, methotrexate, and infliximab was initiated, with resolution of the subretinal fluid. Prednisone was tapered off within 4 months, and the inflammation remains controlled. Conclusions: Infliximab as adjunctive therapy in pediatric VKH showed a benefit in reducing systemic corticosteroid exposure in 1 patient, but incomplete timely resolution of inflammation in another patient.