Inflammatory optic neuropathy in Behçet’s disease

Khanfir, M.; Belfeki, Nabil; Saïd, F.; Salem, T. Ben; Ghorbel, I. Ben; Lamloum, M.; Hamzaoui, A.; Houman, M.H.

doi:10.4081/reumatismo.2015.835

Cited by 10 publications

(4 citation statements)

References 17 publications

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“…In relation to eye involvement in BD, most studies have described an optic neuropathy and retinal pathology with maculopathy and retinal neovascularization ( 19 , 20 ). Studies using optical coherence tomography (OCT) have demonstrated a significant reduction in the thickness of the retinal nerve fiber layer ( 21 ), ganglion cell and inner plexiform layers in patients with BD ( 22 ), while another study showed an initial increase in the nerve fiber layer in those with a short duration of disease, with thinning in those with a longer duration of disease ( 23 ), certainly indicating retinal nerve fiber pathology in patients with BD.…”

Section: Introductionmentioning

confidence: 99%

In Vivo Confocal Microscopic Evaluation of Corneal Nerve Fibers and Dendritic Cells in Patients With Behçet’s Disease

et al. 2018

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Central and peripheral nervous system involvement may occur during the course of Behçet’s disease (BD). In vivo corneal confocal microscopy (CCM) can detect corneal small fiber damage and immune cell density. The aim of this study was to assess central corneal sensitivity, corneal subepithelial nerve plexus morphology and dendritic cell (DC) density in patients with BD. Forty-nine consecutive patients with BD and 30 healthy control subjects were included in this cross-sectional study conducted at a tertiary referral university hospital. Central corneal sensitivity was measured using the contact corneal esthesiometer (Cochet-Bonnet; Luneau, France). The laser scanning CCM (Heidelberg, Germany) was used to quantify corneal nerve fiber density (NFD), nerve branch density (NBD), nerve fiber length (NFL), and DC density. There was a significant reduction in NFD (P = 0.001) and NFL (P = 0.031) and an increase in DC density (P = 0.038) in patients with BD compared to healthy controls, whereas corneal sensitivity (P = 0.066) and NBD (P = 0.067) did not differ significantly. There was no difference in corneal sensitivity, corneal nerve parameters, or DC density between BD patients with [n = 18 (36.7%)] and without a previous history of uveitis (P > 0.05 for all). Disease duration [median (IQR), 6.5 (4.0–14.5) years] correlated with corneal sensitivity (ρ = −0.463; P = 0.001) and NFD (ρ = −0.304; P = 0.034) and corneal sensitivity correlated with NFD (ρ = 0.411; P = 0.003) and NFL (ρ = 0.295; P = 0.039) in patients with BD. CCM demonstrates corneal sub-basal nerve fiber loss and increased DC density, providing a non-invasive ophthalmic means to identify peripheral neuropathy and inflammation in patients with BD.

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Section: Introductionmentioning

confidence: 99%

In Vivo Confocal Microscopic Evaluation of Corneal Nerve Fibers and Dendritic Cells in Patients With Behçet’s Disease

et al. 2018

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“…A more recent article from Tunisia described 10 cases with inflammatory ON among a single-center series of 440 patients with BD. 9 In that series, 50% of the cases had also various forms of other ocular involvement (retinal vasculitis in 1 and anterior/posterior/pan uveitis in 4). In the end, only 20% had vision loss, 40% had improvement, and 40% was stable.…”

Section: Discussionmentioning

confidence: 84%

“…4 Since then, optic neuropathy (ON) has rarely been reported in BD, probably as it was overshadowed by the more common ocular complication of BD, uveitis. 5–9 …”

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confidence: 99%

Characteristics of optic neuropathy in Behçet disease

Akdal

Toydemir

Saatçi

et al. 2018

Neurol Neuroimmunol Neuroinflamm

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ObjectiveWe present the clinical profile, features, and neuroimaging findings of 25 patients with Behçet disease (BD), and optic neuropathy (ON), which has been rarely reported in BD.MethodsData from 5 university hospitals were retrospectively reviewed, and patients with BD and ON were evaluated. There were 2 groups: (1) those already diagnosed with BD when ON developed (BD→ON group) and (2) those diagnosed with BD during the evaluation of ON (ON→BD group).ResultsThere were 25 BD patients with ON (13 males). Among these, 13 had ON→BD, and 12 had BD→ON. Seventeen patients had unilateral ON, and 7 patients had recurrent ON. BD→ON patients were older. Disc edema was seen more in ON→BD than in BD→ON patients (10 vs 3). Fourteen patients also had uveitis, 7 with BD→ON and 7 with ON→BD. There was other neurologic involvement in 8 patients; in the BD→ON group, 4/4 had MS-like disease, in the ON→BD group, 3 had typical parenchymal BD, and 1 had MS-like disease. Twenty of 21 patients received immunosuppressive medications, corticosteroids, or both. Prognosis was favorable in most: vision improved in 20 patients, more often in those receiving combined therapies.ConclusionBD may be diagnosed earlier if it is considered and investigated during the assessment of ON, particularly in high-risk regions. Prognosis of ON related to BD seems to be favorable. Immunosuppressants should be given along with corticosteroids. MS-like presentations should also be kept in mind in patients with BD and ON.

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“…Three of 6 (50%) patients who underwent orbital magnetic resonance imaging (MRI) showed abnormal signals in the optic nerves. Khanfir et al 12 reported 10 patients with inflammatory optic neuropathy. No specific lesions of the optic nerve were noted on neuroradiological studies.…”

Section: Introductionmentioning

confidence: 99%