Ocular Behçet’s Disease: Changing Patterns Over Time, Complications and Long-Term Visual Prognosis

Accorinti, Massimo; Pesci, Francesca Romana; Pirraglia, Maria Pia; Abicca, Irene; Pivetti-Pezzi, Paola

doi:10.3109/09273948.2015.1094095

Cited by 29 publications

(34 citation statements)

References 27 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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“…When considered both the cohorts, more severe findings were observed in males. From the above findings, the authors concluded that timely and aggressive management reduces ocular complications and facilitates better prognosis [47]. Even though uveitis is the common ocular pathology in Behçet's disease, it is not a common cause of uveitis.…”

Section: Eye Manifestationsmentioning

confidence: 96%

Behçet’s Disease: An Enigmatic Malady with Plethoric Expressions

Mohamed¹,

Krishnan²

2020

Different Aspects of Behçet's Disease

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Behçet's disease (BD) is a chronic, inflammatory, repetitive, debilitating systemic vasculitis with conglomerate system involvement of uncharted aetiology portrayed by the triad of oral ulcers, genital ulcers and cutaneous lesions. Behçet's disease has a universal distribution with a predominance among populace with higher prevalence of human leukocyte antigen (HLA) B5 and its split, HLA-B51, in the Mediterranean basin, the Middle East and Far East. This ailment is presently acknowledged to be a multisystem disorder with mucocutaneous, ocular, intestinal, articular, vascular, urogenital, musculoskeletal, cardiopulmonary and neurologic systems and hence bears significant organ sinistering morbidity and mortality. The diagnosis of Behçet's disease relies on scrupulous history, identification of its emblematic clinical countenance as per the diagnostic criteria construed by the International Study Group (ISG) and examination of all pertinent systems and excluding other systemic rheumatic diseases. However, there is a lag in diagnosis because of its plethoric presentations and a dearth of specific biomarkers. The multiple organ and tissue involvement of Behçet's disease necessitates an interdisciplinary approach from various health specialities since a general and an organspecific approach is mandatory. Prime concern is to control the active periods of the disease which is achieved by different anti-inflammatory drugs, steroids or immunomodulators.

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“…12 Significant morbidity is associated with ocular involvement in Behçet's syndrome and NBD, but visual symptoms can improve with prompt treatment. [13][14][15] 3. Initial therapy for parenchymal NBD is high-dose intravenous glucocorticoids (1 g IV methylprednisolone or equivalent) daily for 3-10 days followed by slow prednisone taper with close follow-up.…”

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confidence: 99%

An Exercise in Clinical Reasoning: Do You Unpack?

et al. 2018

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Ocular Behçet’s Disease: Changing Patterns Over Time, Complications and Long-Term Visual Prognosis

Abstract: A significant shift in clinical manifestations of BD patients was observed over 44 years. Immunosuppressive therapy succeeded in lowering ocular complications. The incidence of ocular BD is increasing in females, but visual prognosis is still worse in males.

Cited by 29 publications

References 27 publications

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

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

Behçet’s Disease: An Enigmatic Malady with Plethoric Expressions

An Exercise in Clinical Reasoning: Do You Unpack?

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