Ocular features of Behcet's disease: an international collaborative study

Area of Science:

• Ophthalmology
• Rheumatology
• Immunology

Background:

• Behçet's disease is a multisystem inflammatory disorder.
• Ocular involvement is a major cause of morbidity in Behçet's disease.
• Understanding the global clinical spectrum of ocular Behçet's disease is crucial.

Purpose of the Study:

• To investigate the clinical features of ocular lesions in Behçet's disease across different countries.
• To analyze the prevalence and characteristics of ocular manifestations in a large international cohort.
• To identify potential demographic and geographic variations in the disease presentation and visual outcomes.

Main Methods:

• A descriptive, international, multicenter questionnaire survey was conducted.
• Data were collected from 25 eye centers in 14 countries.
• Clinical data from 1,465 patients with ocular lesions in Behçet's disease were analyzed.

Main Results:

• Recurrent oral aphthous ulcers (94.5%), skin lesions (69.5%), and genital ulcers (61.4%) were common comorbidities.
• Most patients presented with bilateral and recurrent intraocular inflammation.
• Poor visual acuity (<20/200) was observed in 23% of patients, with men experiencing worse outcomes (24.8% vs 18.9%) and higher rates of panuveitis (p<0.01).
• Geographic variations in poor vision were noted, with higher prevalence in India, Iran, and Japan (p<0.01).

Conclusions:

• This study represents the largest international case series of ocular Behçet's disease.
• Panuveitis is more common in men, who also have a poorer visual prognosis.
• Clinical patterns and visual outcomes of ocular Behçet's disease exhibit geographic differences, and the disease continues to lead to significant visual impairment despite treatment.