Monitoring Behçet uveitis

Behçet disease is a systemic vasculitis that can affect various organ systems. Ocular involvement is characterized by recurrent nongranulomatous panuveitis and retinal vasculitis attacks, followed by spontaneous remission periods. Recurrent inflammatory attacks affecting the posterior segment may eventually lead to structural damage and permanent visual loss. The severity of attacks may also be an important factor in visual outcomes. Between attacks, patients may have no clinical signs of inflammatory activity. Therefore, it is crucial to recognize subclinical inflammatory clues in imaging modalities and the structural defects that develop due to previous attacks. Fundus fluorescein angiography (FA) is the gold standard method in monitoring inflammatory activity. Laser flare photometry is a useful noninvasive tool correlating with FA in demonstrating inflammatory activity. Optical coherence tomography (OCT) is the most valuable imaging method in diagnosing and following structural changes. OCT angiography allows visualization of various retinal plexuses separately and evaluation of the retinal vascular structures qualitatively and quantitatively; however, it cannot demonstrate vascular leakage and, therefore, uveitis activity. Monitoring disease activity and structural changes is fundamental in individualizing management, evaluating responses to treatment, and improving long-term outcomes.