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Behçet uveitis: Current practice and future perspectives.

Shereen H Aboul Naga1, Lameece Moustafa Hassan1, Radwa T El Zanaty1

  • 1Ophthalmology Department, Faculty of Medicine, Cairo University Hospital, Uveitis Subspecialty Clinic, Giza, Egypt.

Frontiers in Medicine
|September 26, 2022
PubMed
Summary
This summary is machine-generated.

Behçet's Disease (BD) involves recurrent ulcers and uveitis, impacting the eyes significantly. This review covers its diagnosis, microbiome links, advanced imaging, and treatments including biologics, especially during the COVID-19 pandemic.

Keywords:
Behçet's diseaseCOVID-19biologicsdiagnostic criteriaimmunosuppressionocular investigationuveitis

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Area of Science:

  • Ophthalmology and Immunology
  • Autoinflammatory Diseases
  • Microbiome Research

Background:

  • Behçet's Disease (BD), historically known as 'The Silk Road Disease,' is characterized by recurrent oral and genital ulcers, and uveitis.
  • BD uveitis is a leading cause of non-infectious autoinflammatory eye disease, with increasing prevalence beyond its traditional demographics.
  • Understanding the pathophysiology, particularly the role of the human microbiome, is crucial for advancing BD research.

Purpose of the Study:

  • To provide a comprehensive review of Behçet's Disease (BD), focusing on ocular manifestations and recent advancements.
  • To detail diagnostic approaches, including updated classification criteria and imaging techniques.
  • To explore current and emerging therapeutic strategies, including biologic agents and their comparison with conventional treatments.

Main Methods:

  • Literature review of clinical features, pathophysiology, diagnostic methods, and treatment strategies for Behçet's Disease.
  • Inclusion of recent research on the human microbiome's role in BD pathogenesis.
  • Analysis of advanced diagnostic imaging, specifically Optical Coherence Tomography (OCT) variants (SD, EDI, OCT-angiography).

Main Results:

  • Detailed clinical features of BD, including juvenile-onset forms, and updated diagnostic algorithms.
  • Emphasis on the evolving understanding of BD pathophysiology, incorporating microbiome research.
  • Overview of therapeutic options, contrasting biologic agents (TNF-α, IL-6, IL-1 inhibitors) with corticosteroids and immunosuppressants.

Conclusions:

  • Recent advancements in diagnostics (OCT) and therapeutics (biologics) have significantly improved BD management.
  • The human microbiome is increasingly recognized as a key factor in BD pathogenesis.
  • The review addresses the impact of the SARS-CoV-2 pandemic on BD, including morbidity, treatment, and post-vaccine complications.