Risk and prognostic factors of poor visual outcome in Behcet's disease with ocular involvement

Takeuchi, Masaru; H, Hokama; Tsukahara, Rintaro; Kezuka, Takeshi; Gotô, Hiroshi; Sakai, Jun‐ichi; Usui, Masahiko

doi:10.1007/s00417-005-0005-8

Cited by 77 publications

(69 citation statements)

References 25 publications

(29 reference statements)

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“…34 According to this, we also detected a higher rate of posterior uveitis in HLA-B51-positive patients (P ¼ 0.038) in our series, whereas others did not find this correlation. 35 In contrast to the data of the German registry published by Zouboulis et al, 8 Kö tter et al 10 did not find any correlation of HLA-B51 and eye involvement in their study published in 2004. Reasons might be the small number of patients in the second study and a different genetic background of the German population of northeast and southwest Germany.…”

Section: Discussionmentioning

confidence: 70%

Ocular involvement is associated with HLA-B51 in Adamantiades–Behçet's disease

Krause

Altenburg

et al. 2008

Eye

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Purpose To evaluate the association of HLA-B51 and ocular involvement in Adamantiades-Behçet's disease. Methods We retrospectively analysed all patients with Adamantiades-Behçet's disease examined in our Department of Ophthalmology since 1982. All patients fulfilled the criteria of the International Study Group for Behçet's disease. We included 140 patients (63 female and 77 male) with a mean follow-up of 6.4 years. Results The mean age at the first manifestation was 23 years; full disease was noted at 32 years. The mean age at the time of eye involvement was 30 years. Most of the patients were of Turkish (n ¼ 73) or German (n ¼ 34) origin. A total of 56% patients developed eye involvement. Forty-nine out of 76 HLA-B51-positive patients (64.5%) and 26 out of 60 HLA-B51-negative patients (43.3%; P ¼ 0.014) developed ocular involvement. Conclusion More than the half of the patients with Adamantiades-Behçet's disease evaluated in our department developed ocular involvement. There was a statistically significantly higher frequency of HLA-B51 in these patients.

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Section: Discussionmentioning

confidence: 70%

Ocular involvement is associated with HLA-B51 in Adamantiades–Behçet's disease

Krause

Altenburg

et al. 2008

Eye

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“…On the basis of the ophthalmologists' judgment, we intensified therapy by shortening the intervals of IFX in refractory patients who had experienced more frequent and severe ocular attacks, which appeared to be the risk and poor prognostic factors for the outcome of VA in BD (14). Therefore, the 32 patients who continuously received IFX infusions for 2 years were divided into groups that received standard treatment at a dose of 5 mg/kg every 8 weeks (group I) and those that received treatment at a dose of 5 mg/kg every 6-7 weeks (group II).…”

Section: Prediction Of Responsiveness To Ifx Therapymentioning

confidence: 99%

Long-term efficacy of infliximab treatment and the predictors of treatment outcomes in patients with refractory uveitis associated with Behçet’s disease

et al. 2018

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Objective: To assess the long-term efficacy and safety of infliximab (IFX) treatment for refractory uveitis associated with Behçet's disease (BD) and to identify predictors of long-term IFX therapy outcomes. Material and Methods: We retrospectively studied 44 consecutive BD patients with uveitis who were started on IFX therapy and analyzed the efficacy and safety of IFX and the treatment continuation rate. To determine predictors of IFX responsiveness, we analyzed the clinical characteristics of the patients who received regular maintenance therapy and those who required treatment intensification. The serum cytokine levels prior to IFX were measured through the Bio-Plex human cytokine assays. Results: IFX significantly reduced the frequency of ocular attacks and improved the visual acuity of patients with BD-related uveitis. However, approximately half of the patients required dose escalations, necessitating a shortening of the intervals between IFX infusions due to loss of efficacy during the 5-year treatment. The frequency of ocular attacks was significantly higher in patients with complete BD than in patients with incomplete BD. A multiplex cytokine analysis revealed that patients with BD-related uveitis exhibited increased serum IL-2, IL-6, IL-8, and MCP-1 levels. Moreover, among BD patients, the serum IL-2 and IL-6 levels were particularly high in those who maintained remission and received regular IFX treatments. Conclusion: We confirmed the long-term efficacy and tolerability of IFX in patients with BD-related uveitis. Our results indicate that complete BD may be less responsive to IFX and that the pretreatment serum cytokine profiles may be useful for predicting the long-term IFX therapy outcomes.

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“…The degree and extent of retinal vascular leakage and non-perfusion, in particular, have been correlated with long-term visual prognosis. 26,27 Ultra-widefield (UW) color and angiographic imaging of the mid-and far-periphery appeared to be particularly important and have been shown to provide additional, therapeutically important information in a majority of patients. 28,29 Routine indocyanine green angiography (ICGA) and fundus autofluroescence (FAF), which document the location and extent of involvement of the choroid and retinal pigment epithelium (RPE), respectively, provide generally less direct determinants of therapy and, therefore, were not recommended routinely once the diagnosis of BU was established.…”

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confidence: 99%