Original article
Uveitis in Behçet disease: An analysis of 880 patients

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Abstract

Purpose

We aimed to describe the demographic and clinical features, ocular manifestations, complications, visual prognosis, and treatment in a large population of Turkish patients with Behçet uveitis. We also aimed to compare visual prognosis between male and female sex and between patients who presented before and after 1990.

Design

Observational case series.

Methods

A retrospective study of 880 consecutive patients (1,567 eyes) with Behçet uveitis seen at the Uveitis Service, Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, from 1980 to 1998. All patients met the classification criteria of the International Study Group for Behçet's Disease. Information on the patient's sex, age at onset of uveitis, ocular features, ocular complications, visual acuity, and systemic treatment was collected.

Results

Five hundred ninety-nine patients (68%) were male and 281 (32%) were female. The mean age at onset of uveitis was 28.5 years in male and 30 years in female patients. Ocular involvement was bilateral in 78.1% and unilateral in 21.9% of the patients. Panuveitis was the most common form in both sexes. Fundus lesions as well as sight-threatening complications were more common in males. At the beginning of the follow-up, potential visual acuity was 0.1 or less in 30.9% of eyes in males and 24.2% of eyes in females. Kaplan-Meier survival analysis estimated the risks of losing useful vision (>0.1) at 5 and 10 years for males and females as 21% vs 10% and 30% vs 17%, respectively. Male patients who presented in the 1990s had a significantly lower risk of losing vision compared with male patients who presented in the 1980s.

Conclusion

Behçet uveitis starts frequently around the end of the third decade and has a male predominance. The disease is more severe and the risk of losing useful vision is higher in males than in females. However, this risk has been significantly reduced in the 1990s.

Section snippets

Methods

We reviewed the medical records of 880 consecutive patients with ocular involvement of Behçet disease who visited the Uveitis and Immunology Service of the Ophthalmology Department, Istanbul University, Istanbul Faculty of Medicine, from 1980 to 1998. All patients were Turkish Caucasians. Only patients who met the 1990 classification criteria of the International Study Group for Behçet's Disease were included in the study.10 Patients who had ocular involvement other than uveitis were excluded.

Results

A total of 880 patients were included in the study. Mean age at presentation was 30 years (range, 9 to 71 years). Five hundred ninety-nine patients (68%) were male and 281 patients (32%) were female. Male-to-female ratio was 2.1:1. The total number of involved eyes was 1,567 (1,075 eyes in males and 492 eyes in females).

Extraocular clinical manifestations of Behçet disease are shown in Table 1. All patients had recurrent oral ulcers. The second most common extraocular clinical manifestation

Discussion

Uveitis in Behçet disease carries significant implications for the patient, because it is a chronic recurrent disease characterized by explosive attacks of severe inflammation that may cause significant damage to the intraocular structures. However, there are individual variations in disease course and severity, and several risk factors have been implicated to be associated with a severe course and a poor visual prognosis. Studies of large number of patients may help us improve our knowledge of

Supplementary files

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