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[Ocular manifestations in Behçet's disease].
A-C Desbois1, C Terrada2, P Cacoub1
1Sorbonne universités, UPMC université Paris 06, UMR 7211, et DHU i2B-inflammation-immunopathologie-biothérapie, 75005 Paris, France; Inserm, UMR_S 959, 75013 Paris, France; CNRS, FRE3632, 75005 Paris, France; Département de médecine interne et d'immunologie clinique, université Pierre-et-Marie-Curie, groupe hospitalier Pitié-Salpêtrière, AP-HP, 75013 Paris, France; Centre national de référence des maladies auto-immunes systémiques rares, centre national de référence des maladies auto-inflammatoires et de l'amylose, France.
La Revue De Medecine Interne
|April 8, 2018
Summary
Behçet
Area of Science:
- Ophthalmology
- Rheumatology
- Immunology
Background:
- Behçet's disease frequently causes ocular complications, with uveitis being the most common manifestation.
- Ocular involvement can precede or follow systemic symptoms by years, posing a diagnostic challenge.
- Significant risk of vision loss exists, primarily from macular edema and retinal vasculitis.
Purpose of the Study:
- To review the ocular manifestations of Behçet's disease.
- To discuss diagnostic criteria and prognostic factors for visual impairment.
- To outline current and emerging therapeutic strategies for Behçet's disease-associated uveitis.
Main Methods:
- Literature review of ocular manifestations in Behçet's disease.
- Analysis of diagnostic criteria and risk factors for vision loss.
- Evaluation of treatment outcomes for various therapeutic interventions.
Main Results:
- Uveitis, particularly posterior involvement, is a major cause of visual morbidity in Behçet's disease.
- Male gender, younger age at onset, and severe initial lesions correlate with poorer visual prognosis.
- Standard treatments (corticosteroids, azathioprine) may be insufficient for severe cases, necessitating advanced therapies.
Conclusions:
- Early diagnosis and aggressive management are crucial for preserving vision in Behçet's disease-associated uveitis.
- Anti-TNF-alpha and interferon-alpha therapies have significantly improved visual outcomes in severe cases.
- Multidisciplinary care is essential for managing this chronic, potentially blinding condition.