Sequential bilateral Behçet's neuroretinitis associated with prepapillary vitreous exudate: case report

Area of Science:

• Ophthalmology
• Rheumatology
• Immunology

Background:

• Behçet disease (BD) is a multisystemic inflammatory disorder.
• Ocular involvement, particularly uveitis, is common in BD.
• Neuroretinitis with prepapillary inflammatory vitreous exudate (PIVE) is a rare but distinct ocular manifestation.

Purpose of the Study:

• To describe a unique case of BD uveitis.
• To highlight sequential bilateral neuroretinitis with PIVE.
• To illustrate the diagnostic utility of multimodal imaging in BD.

Main Methods:

• A single case report was documented.
• Multimodal imaging, including Swept Source (SS) OCT and OCT angiography (OCTA), was utilized.
• Clinical presentation and disease course were meticulously recorded.

Main Results:

• A 37-year-old male presented with sequential bilateral neuroretinitis and PIVE.
• Initial diagnosis was ocular toxoplasmosis, but extraocular BD features emerged later.
• SS OCT revealed characteristic "mushroom-shaped" PIVE, and OCTA showed peripapillary hypervascularity and flow signal loss.

Conclusions:

• Sequential bilateral neuroretinitis with PIVE can precede overt clinical signs of BD.
• SS OCT and OCTA are valuable tools for diagnosing and managing this specific BD uveitis presentation.
• Early recognition and appropriate therapy are crucial for visual outcomes in BD uveitis.