Topical difluprednate for the treatment of Harada’s disease

Purpose: To describe the use of topical difluprednate for treatment of patients who presented with Harada’s disease. Methods: Retrospective case series of patients managed with topical difluprednate alone at the onset of the diagnosis. The patients were followed with optical coherence tomography (OCT) and fluorescein angiography. Results: In our three cases, complete resolution of the exudative detachments with improvement in visual acuity was achieved in each case. Central macular thickness was reduced by a mean of 365±222 µm. Initial loading dose was one drop every hour while awake, followed by a variable tapering regimen. Leakage on fluorescein angiography and exudative detachments on OCT both responded to treatment with difluprednate. In two of the three cases, the patients recovered vision to 20/20, and the third case recovered to 20/25. Steroid-induced glaucoma was observed and managed with one to two glaucoma drops as needed. Conclusion: Difluprednate is effective for managing ocular manifestations of Harada’s disease. Further studies of this drug for the management of noninfectious posterior uveitis are warranted. Keywords: serous retinal detachment, noninfectious posterior uveitis, steroid