Skip to main content
Top
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology 7/2017

01-07-2017 | Inflammatory Disorders

Pattern and causes of visual loss in Behçet’s uveitis: short-term and long-term outcomes

Authors: Radgonde Amer, Walaa Alsughayyar, Diego Almeida

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 7/2017

Login to get access

Abstract

Background

To analyze the pattern and causes of visual loss in patients with Behçet’s uveitis and to report on the short-term outcome at 6 months and at last follow-up visit. Also, to analyze the pattern of visual acuity changes in eyes with and without macular involvement at the specified time points.

Methods

This is a retrospective cohort study of a single-center in an academic practice. Fifty-three patients with Behçet’s uveitis evaluated between 2004 and 2014 were included. Data on patients diagnosed with Behçet’s uveitis were entered retrospectively into a database and analyzed.

Results

Included were 93 eyes with Behçet’s uveitis involving the posterior segment. Frequencies of ≤20/50 and of ≤20/200 VA at presentation were 23.7% and 37.6%, respectively. Retinitis, macular inflammatory infiltrate, and dense vitritis were significantly associated with worse vision. Eyes with macular atrophy and macular inflammatory infiltrate sustained the worst logMAR VA at presentation (1.87 and 1.73, respectively) compared to eyes with cystoid macular edema and epiretinal membrane (0.76 and 0.63, respectively). Eyes with no macular involvement had the best VA at presentation. Mean difference in logMAR VA between presentation and the specified time points was greatest for eyes with macular inflammatory infiltrate.

Conclusions

Behçet’s disease affected mostly young males with a male-to-female ratio of 4.8:1. Panuveitis and posterior uveitis were the predominant forms and they were intrinsically associated with sight-threatening potential and breadth of ocular complications for which aggressive immunosuppressive therapy was essential.
Literature
2.
go back to reference Evereklioglu C (2005) Review. Current concepts in the etiology and treatment of Behçet disease. Surv Ophthalmol 50(4):297–350CrossRefPubMed Evereklioglu C (2005) Review. Current concepts in the etiology and treatment of Behçet disease. Surv Ophthalmol 50(4):297–350CrossRefPubMed
3.
go back to reference International Study Group for Behçet’s Disease (1990) Evaluation of diagnostic (‘classification’) criteria in Behçet’s disease: toward internationally agreed criteria. Lancet 335:1078–1080 International Study Group for Behçet’s Disease (1990) Evaluation of diagnostic (‘classification’) criteria in Behçet’s disease: toward internationally agreed criteria. Lancet 335:1078–1080
4.
go back to reference Jabs DA, Nussenblatt RB, Rosenbaum JT et al (2005) Standardization of uveitis nomenclature for reporting clinical data. Results of the first international workshop. Am J Ophthalmol 140:509–516CrossRefPubMed Jabs DA, Nussenblatt RB, Rosenbaum JT et al (2005) Standardization of uveitis nomenclature for reporting clinical data. Results of the first international workshop. Am J Ophthalmol 140:509–516CrossRefPubMed
5.
go back to reference Nussenblatt RB, Palestine AG, Chan CC, Roberge F (1985) Standardization of vitreal inflammatory activity in intermediate and posterior uveitis. Ophthalmology 92:467–471CrossRefPubMed Nussenblatt RB, Palestine AG, Chan CC, Roberge F (1985) Standardization of vitreal inflammatory activity in intermediate and posterior uveitis. Ophthalmology 92:467–471CrossRefPubMed
6.
go back to reference Behcet’s Disease Research Committee of Japan (1974) Behcet’s disease guide to the diagnosis of Behcet’s disease (1972). Jpn J Ophthalmol 18:291–294 Behcet’s Disease Research Committee of Japan (1974) Behcet’s disease guide to the diagnosis of Behcet’s disease (1972). Jpn J Ophthalmol 18:291–294
7.
go back to reference Tugal-Tutkun I, Onal S, Altan-Yaycioglu R, Huseyin Altunbas H, Urgancioglu M (2004) Uveitis in Behçet disease: an analysis of 880 patients. Am J Ophthalmol 138(3):373–380CrossRefPubMed Tugal-Tutkun I, Onal S, Altan-Yaycioglu R, Huseyin Altunbas H, Urgancioglu M (2004) Uveitis in Behçet disease: an analysis of 880 patients. Am J Ophthalmol 138(3):373–380CrossRefPubMed
8.
go back to reference Arevalo JF, Lasave AF, Al Jindan MY, KKESH Uveitis Survey Study Group; KKESH Uveitis Survey Study Group et al (2015) Uveitis in Behçet disease in a tertiary center over 25 years: the KKESH uveitis Survey study group. Am J Ophthalmol 159(1):177–184CrossRefPubMed Arevalo JF, Lasave AF, Al Jindan MY, KKESH Uveitis Survey Study Group; KKESH Uveitis Survey Study Group et al (2015) Uveitis in Behçet disease in a tertiary center over 25 years: the KKESH uveitis Survey study group. Am J Ophthalmol 159(1):177–184CrossRefPubMed
9.
go back to reference Yoshida A, Kawashima H, Motoyama Y et al (2004) Comparison of patients with Behçet’s disease in the 1980s and 1990s. Ophthalmology 111:810–815CrossRefPubMed Yoshida A, Kawashima H, Motoyama Y et al (2004) Comparison of patients with Behçet’s disease in the 1980s and 1990s. Ophthalmology 111:810–815CrossRefPubMed
10.
go back to reference Dana MR, Merayo-Lloves J, Schaumberg DA, Foster CS (1997) Visual outcomes prognosticators in juvenile rheumatoid arthritis-associated uveitis. Ophthalmology 104(2):236–244CrossRefPubMed Dana MR, Merayo-Lloves J, Schaumberg DA, Foster CS (1997) Visual outcomes prognosticators in juvenile rheumatoid arthritis-associated uveitis. Ophthalmology 104(2):236–244CrossRefPubMed
11.
go back to reference Hatemi G, Silman A, Bang D et al (2008) EULAR expert committee. EULAR recommendations for the management of Behçet disease. Ann Rheum Dis 67(12):1656–1662CrossRefPubMed Hatemi G, Silman A, Bang D et al (2008) EULAR expert committee. EULAR recommendations for the management of Behçet disease. Ann Rheum Dis 67(12):1656–1662CrossRefPubMed
12.
go back to reference Khairallah M, Attia S, Yahia SB et al (2009) Pattern of uveitis in Behçet’s disease in a referral center in Tunisia, North Africa. Int Ophthalmol 29(3):135–141CrossRefPubMed Khairallah M, Attia S, Yahia SB et al (2009) Pattern of uveitis in Behçet’s disease in a referral center in Tunisia, North Africa. Int Ophthalmol 29(3):135–141CrossRefPubMed
13.
go back to reference Kaçmaz RO, Kempen JH, Newcomb C, Systemic Immunosuppressive Therapy for Eye Diseases Cohort Study Group et al (2008) Ocular inflammation in Behçet disease: incidence of ocular complications and of loss of visual acuity. Am J Ophthalmol 146(6):828–836CrossRefPubMedPubMedCentral Kaçmaz RO, Kempen JH, Newcomb C, Systemic Immunosuppressive Therapy for Eye Diseases Cohort Study Group et al (2008) Ocular inflammation in Behçet disease: incidence of ocular complications and of loss of visual acuity. Am J Ophthalmol 146(6):828–836CrossRefPubMedPubMedCentral
14.
go back to reference Yang P, Fang W, Meng Q, Ren Y, Xing L, Kijlstra A (2008) Clinical features of Chinese patients with Behçet’s disease. Ophthalmology 115(2):312–318.e4CrossRefPubMed Yang P, Fang W, Meng Q, Ren Y, Xing L, Kijlstra A (2008) Clinical features of Chinese patients with Behçet’s disease. Ophthalmology 115(2):312–318.e4CrossRefPubMed
15.
go back to reference Kaburaki T, Namba K, Sonoda KH, Ocular Behçet Disease Research Group of Japan et al (2014) Behçet’s disease ocular attack score 24: evaluation of ocular disease activity before and after initiation of infliximab. Jpn J Ophthalmol 58(2):120–130CrossRefPubMed Kaburaki T, Namba K, Sonoda KH, Ocular Behçet Disease Research Group of Japan et al (2014) Behçet’s disease ocular attack score 24: evaluation of ocular disease activity before and after initiation of infliximab. Jpn J Ophthalmol 58(2):120–130CrossRefPubMed
17.
go back to reference Cingu AK, Onal S, Urgancioglu M, Tugal-Tutkun I (2012) Comparison of presenting features and three-year disease course in Turkish patients with Behçet uveitis who presented in the early 1990s and the early 2000s. Ocul Immunol Inflamm 20:423–428CrossRefPubMed Cingu AK, Onal S, Urgancioglu M, Tugal-Tutkun I (2012) Comparison of presenting features and three-year disease course in Turkish patients with Behçet uveitis who presented in the early 1990s and the early 2000s. Ocul Immunol Inflamm 20:423–428CrossRefPubMed
18.
go back to reference Taylor SR, Singh J, Menezo V, Wakefield D, McCluskey P, Lightman S (2011) Behçet disease: visual prognosis and factors influencing the development of visual loss. Am J Ophthalmol 152:1059–1066CrossRefPubMed Taylor SR, Singh J, Menezo V, Wakefield D, McCluskey P, Lightman S (2011) Behçet disease: visual prognosis and factors influencing the development of visual loss. Am J Ophthalmol 152:1059–1066CrossRefPubMed
Metadata
Title
Pattern and causes of visual loss in Behçet’s uveitis: short-term and long-term outcomes
Authors
Radgonde Amer
Walaa Alsughayyar
Diego Almeida
Publication date
01-07-2017
Publisher
Springer Berlin Heidelberg
Published in
Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 7/2017
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-017-3667-0

Other articles of this Issue 7/2017

Graefe's Archive for Clinical and Experimental Ophthalmology 7/2017 Go to the issue

Letter to the Editor (by invitation)

A recent finding in Fuchs uveitis: choroidal thinning