Risk and prognostic factors of poor visual outcome in Behcet's disease with ocular involvement

Abstract Purpose To determine the application of fluorescein angiographic (FA) findings and Behcet’s disease ocular attack score 24 (BOS24) scoring system in predicting poor visual outcome in patients with ocular Behcet’s disease. Study design Retrospective cohort study. Methods We included 73 eyes of 38 patients with ocular Behcet’s disease who underwent FA and reviewed FA images, anterior chamber cells, vitreous opacity, retinal and optic disc lesions, which are parameters in BOS24. The correlation between FA findings, BOS24, and visual acuity was assessed. Results Optic disc hyperfluoresence (74%), diffuse posterior pole leakage (52%) and diffuse peripheral leakage (52%) were the three most common findings. Common complications were peripheral capillary nonperfusion (29%), arterial narrowing (22%), and macular ischemia (19%). BOS24 scores of ≥ 6 (p < 0.0001), arterial narrowing (p < 0.0001), and severe posterior pole leakage (p = 0.004) were significantly associated with poor visual outcome. Combining significant FA findings: arterial narrowing and severe posterior pole leakage, to BOS24 ≥ 6 results in an increased relative risk of developing poor visual acuity from 7.30 to 10.43 and 1.89 to 2.02 respectively. Conclusion Fluorescein angiography is an important investigation for predicting poor visual outcome. BOS24 may be a useful alternative when fluorescein angiographic is unavailable.

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Old and New Challenges in Uveitis Associated with Behçet’s Disease

Journal of Clinical Medicine ◽

10.3390/jcm10112318 ◽

2021 ◽

Vol 10 (11) ◽

pp. 2318

Author(s):

Julie Gueudry ◽

Mathilde Leclercq ◽

David Saadoun ◽

Bahram Bodaghi

Keyword(s):

Behçet’S Disease ◽

Structural Damage ◽

Behcet’S Disease ◽

Behçet's Disease ◽

Systemic Vasculitis ◽

Retinal Vasculitis ◽

Unknown Origin ◽

Current Data ◽

Ocular Involvement ◽

Behcet's Disease

Behçet’s disease (BD) is a systemic vasculitis disease of unknown origin occurring in young people, which can be venous, arterial or both, classically occlusive. Ocular involvement is particularly frequent and severe; vascular occlusion secondary to retinal vasculitis may lead to rapid and severe loss of vision. Biologics have transformed the management of intraocular inflammation. However, the diagnosis of BD is still a major challenge. In the absence of a reliable biological marker, diagnosis is based on clinical diagnostic criteria and may be delayed after the appearance of the onset sign. However, therapeutic management of BD needs to be introduced early in order to control inflammation, to preserve visual function and to limit irreversible structural damage. The aim of this review is to provide current data on how innovations in clinical evaluation, investigations and treatments were able to improve the prognosis of uveitis associated with BD.

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Interleukin-2 gene polymorphism in Turkish patients with Behçet's disease and its association with ocular involvement

International Journal of Immunogenetics ◽

10.1111/iji.12039 ◽

2013 ◽

Vol 40 (5) ◽

pp. 349-355 ◽

Cited By ~ 5

Author(s):

A. Yücel ◽

K. Dilek ◽

D. Saba ◽

A. A. Özçimen ◽

M. Yurtkuran ◽

...

Keyword(s):

Gene Polymorphism ◽

Behçet’S Disease ◽

Behcet’S Disease ◽

Behçet's Disease ◽

Interleukin 2 ◽

Ocular Involvement ◽

Behcet's Disease ◽

Turkish Patients

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FRI0169 Cyclosporin a versus Ýnterferon alfa in treatment of severe ocular involvement of behÇet’s disease

10.1136/annrheumdis-2001.229 ◽

2001 ◽

Author(s):

A Dýnc ◽

S Pay ◽

Z Bayraktar ◽

H Erdem ◽

M Turan

Keyword(s):

Cyclosporin A ◽

Behçet’S Disease ◽

Behcet’S Disease ◽

Behçet's Disease ◽

Ocular Involvement ◽

Behcet's Disease

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MiR-146a and miR-155 polymorphisms in Egyptian patients with Behcet’s disease

Archives of Medical Science ◽

10.5114/aoms/105349 ◽

2021 ◽

Author(s):

Omayma Abdelaleem ◽

Olfat Shaker

Keyword(s):

Risk Factor ◽

Behçet’S Disease ◽

Behcet’S Disease ◽

Behçet's Disease ◽

Recessive Model ◽

Additive Models ◽

Ocular Involvement ◽

Behcet's Disease ◽

Egyptian Population ◽

Egyptian Patients

IntroductionBackground: The current study designed to analyze whether polymorphisms of miR-146a and miR-155 are related to Behçet’s disease (BD) in Egyptian population.Material and methodsMethods: A total of 96 unrelated BD patients and 100 healthy subjects were genotyped for miR-146a (rs2910164) and miR-155(rs767649) using real-time polymerase chain reaction.ResultsResults: the results showed significant elevation in the frequency of rs2910164 GG and CC genotypes in BD patients compared with controls (adjusted OR = 22.156, 95% CI (4.728-103.818); P < 0.001 and adjusted OR = 40.358, 95% CI (8.928 -182.440); P < 0.001, respectively). Also, rs2910164 G allele conferred a higher risk of developing BD (adjusted OR = 3.665, 95% CI (2.013-6.671); P < 0.001). MiR-146a (rs2910164) polymorphism was a risk factor for susceptibility to BD in dominant, recessive and additive models of inheritance(All P < 0.001), while, the miR-155(rs767649) polymorphism was a risk factor in recessive model only (P = 0.021). GG and CG genotypes of rs2910164 were associated with higher BDCAI activity and ocular involvement compared with CC genotype (P = 0.005 and P =0.004, respectively). Genotype AT of rs767649 was related to higher BDCAI activity (P = 0. 026) compared with TT or AA genotypes.ConclusionsConclusion: The miR-146a (rs2910164) and miR-155(rs767649) were likely to play an important role in Egyptian population to develop BD and also influence disease severity.

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Immunopathogenesis of Ocular Behçet’s Disease

Journal of Immunology Research ◽

10.1155/2014/653539 ◽

2014 ◽

Vol 2014 ◽

pp. 1-13 ◽

Cited By ~ 11

Author(s):

Un Chul Park ◽

Tae Wan Kim ◽

Hyeong Gon Yu

Keyword(s):

Behçet’S Disease ◽

Behcet’S Disease ◽

Behçet's Disease ◽

Retinal Vasculitis ◽

Skin Lesions ◽

Unknown Etiology ◽

Ocular Involvement ◽

Inflammatory Disorder ◽

General Hypothesis ◽

Behcet's Disease

Behçet’s disease (BD) is a chronic recurrent systemic inflammatory disorder of unknown etiology characterized by oral and genital ulcerations, skin lesions, and uveitis. The ocular involvement of BD, or Behçet’s uveitis (BU), is characterized by panuveitis or posterior uveitis with occlusive retinal vasculitis and tends to be more recurrent and sight threatening than other endogenous autoimmune uveitides, despite aggressive immunosuppression. Although pathogenesis of BD is unclear, researches have revealed that immunological aberrations may be the cornerstone of BD development. General hypothesis of BD pathogenesis is that inflammatory response is initiated by infectious agents or autoantigens in patients with predisposing genetic factors and perpetuated by both innate and acquired immunity. In addition, a network of immune mediators plays a substantial role in the inflammatory cascade. Recently, we found that the immunopathogenesis of BU is distinct from other autoimmune uveitides regarding intraocular effector cell profiles, maturation markers of dendritic cells, and the cytokine/chemokine environment. In addition, accumulating evidence indicates the involvement of Th17 cells in BD and BU. Recent studies on genetics and biologics therapies in refractory BU also support the immunological association with the pathogenesis of BU. In this review, we provide an overview of novel findings regarding the immunopathogenesis of BU.

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Clinical Findings, Diagnosis, and Classification of Behçet's Disease

Güncel Retina Dergisi (Current Retina Journal) ◽

10.37783/crj-0114 ◽

2018 ◽

pp. 329-333

Keyword(s):

Behçet’S Disease ◽

Behcet’S Disease ◽

Behçet's Disease ◽

Retinal Vasculitis ◽

Clinical Findings ◽

Unknown Etiology ◽

Ocular Involvement ◽

Behcet's Disease ◽

Diagnosis And Classification

Behçet’s Disease (BD) is a chronic multisystem vasculitis with unknown etiology, which is characterized by the triad of recurrent oral ulcers, genital ulcers, and iritis. The eye is one of the most commonly affected organs and typical ocular involvement is panuveitis with hypopyon and retinal vasculitis. The diagnosis is based on clinical evaluation including biomicroscopic and funduscopic examination. This article aims to review the clinical findings, diagnosis, and classification of BD.

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Neuro-ophthalmological manifestations of Behçet’s disease

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2017-311334 ◽

2018 ◽

Vol 103 (1) ◽

pp. 83-87 ◽

Cited By ~ 2

Author(s):

Ammr Alghamdi ◽

Bahram Bodaghi ◽

Chloé Comarmond ◽

Anne Claire Desbois ◽

Fanny Domont ◽

...

Keyword(s):

Visual Acuity ◽

Behçet’S Disease ◽

Cranial Nerve ◽

Cranial Nerve Palsy ◽

Nerve Palsy ◽

Behcet’S Disease ◽

Behçet's Disease ◽

Visual Outcome ◽

Ophthalmological Examination ◽

Behcet's Disease

BackgroundThe neuro-ophthalmological manifestations of Behcet’s disease (BD) are rare, and data regarding their characteristics and outcome are lacking.ObjectiveTo report prevalence, main characteristics and outcome of neuro-ophthalmological manifestations in BD.Patients and methodsThis is a retrospective monocentric study of 217 patients diagnosed with neuro-Behçet’s disease (NBD), of whom 29 (13.3%) patients presented with neuro-ophthalmological manifestations (55% of men and mean±SD age of 26±8 years). All patients underwent a detailed ophthalmological examination and were followed up in the internal medicine and the ophthalmology departments.ResultsNeuro-ophthalmological manifestations were the first presentation of BD in 45% of patients and developed later in the course of the disease in 55% of patients. They are divided into parenchymal (PM) and non-parenchymal (NPM)-related manifestations in, respectively, 13 patients (45%) and 16 patients (55%). PM included papillitis in seven patients (53.8%), retrobulbar optic neuritis in four patients (30.8%) and third cranial nerve palsy in two patients (15.4%). NPM included papilloedema related to cerebral venous thrombosis in all 16 patients, of whom 6 patients (37.5%) had sixth cranial nerve palsy. At initial examination, 93.1% of patients had visual alterations, including mainly decreased visual acuity visual field defects and/or diplopia. All patients were treated with corticosteroids and 79% of patients received immunosuppressive agents. After treatment, the visual outcome improved or stabilised in 66.7% of patients while it worsened in 33.3. The mean±SD logarithm of the minimum angle of resolution visual acuity improved from 0.4±0.3 at diagnosis to 0.2±0.3 after therapy. 10.3% and 3.4% of patients were legally blind at diagnosis and after therapy, respectively.ConclusionNeuro-ophthalmological manifestations of BD represented 13% of NBD. They could be potentially severe and disabling. Prompt treatment is the key factor in improving visual outcome.

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