Prognostic factors of vision in patients with Behçet disease

Behçet disease is a chronic, recurrent, inflammatory disorder characterized by the triad of oral and genital ulcers and ocular lesions. The etiology is unknown. Although many of these patients become blind, some have good vision all their life.

To attain more accurate data on the prognosis of these patients, the authors studied 52 Japanese patients (101 eyes) seen at Kyushu University Hospital between 1980 and 1990. At the first visit, patients ranged in age from 21 to 61 years; at onset, they ranged in age from 17 to 55 years; and the disease duration at first visit was from 0 to 22 years. Thirty-five of the 101 eyes had a visual loss of more than five lines or the patients became blind. The authors divided the subjects into two groups--favorable group and unfavorable group. If an eye had more than five lines of visual loss or the patient became blind 3 years after the first visit, it was placed in the unfavorable group, and if not, it was classed in the favorable group. Thirty-two factors determined from clinical records were used to select statistically significant risk factors for visual loss, using univariate analysis and multivariate logistic regression analysis.

Univariate analysis showed the following four factors that were significantly different between favorable and unfavorable groups: sex, disease interval, other complications, and skin lesions (first year). Multivariate analysis showed that the following seven factors had mutually independent contributions to visual loss: skin lesions; arthritis; posterior attacks; other complications (experienced), including gastrointestinal, vascular, and central nervous system lesions; female sex; disease interval; and anterior attacks. The first four factors have effects of losing vision, whereas the others are related to vision retention.

The authors find that skin lesions, arthritis, posterior attacks, and other complications are linked to loss of vision, whereas female sex, disease interval, and anterior attacks are related to retention of vision.