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Pattern and causes of visual loss in Behçet's uveitis: short-term and long-term outcomes
Radgonde Amer1, Walaa Alsughayyar2, Diego Almeida2
1Department of Ophthalmology, Hadassah Medical Center, Jerusalem, Israel. radgonde@gmail.com.
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.