International consensuses and guidelines on managing ocular Behçet’s disease by the Academy of Asia-Pacific Professors of Ophthalmology (AAPPO), the Asia-Pacific Vitreo-Retina Society (APVRS), the Asia-Pacific Society of Ocular Inflammation and Infection (APSOII) and the Academia Retina Internationalis (ARI)

Chan V. T., Mak A. C., Agrawal R., Biswas J., Bodaghi B., Chan C. K., ...Daha Fazla

Asia-Pacific Journal of Ophthalmology, cilt.14, sa.6, 2025 (SCI-Expanded, Scopus) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 14 Sayı: 6
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1016/j.apjo.2025.100261
  • Dergi Adı: Asia-Pacific Journal of Ophthalmology
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Anahtar Kelimeler: Adamantiades-Behçet's disease, Behçet's disease, Behçet's syndrome, Behçet's uveitis, Uveitis
  • İstanbul Üniversitesi Adresli: Evet

Özet

Behçet’s disease remains a complex and challenging form of uveitis, marked by a high rate of relapse, significant inflammation, and a long-term risk of visual acuity loss. The introduction of biologics, especially anti-tumour necrosis factor (TNF) agents, has revolutionized treatment, significantly reducing sight-threatening complications and minimizing the adverse effects of steroid therapy. However, several challenges persist, including variable clinical presentations, a high incidence of vasculitis affecting both the retinal and systemic circulation, the recognition of neuro-Behçet’s disease, and the lack of tools for disease activity monitoring or biomarkers for diagnostic specificity and progression tracking. Additional issues such as the exit strategy for biologics and the cost-effectiveness of genetic testing further complicate its management. To address these complexities, the Academy of Asia-Pacific Professors of Ophthalmology (AAPPO), the Asia-Pacific Vitreo-retina Society (APVRS), the Asia-Pacific Society of Ocular Inflammation and Infection (APSOII), and the Academia Retina Internationalis (ARI) formed a panel of 21 international experts from 11 countries and territories. This consensus manuscript reflects a systematic review of existing literature and the collective insights of these experts. The panel reviewed key topics, discussed controversies, and achieved consensus in areas including classification, diagnosis, systemic treatment, special groups such as pediatric or neuro-Behçet’s cases, and advancements in genetic stratification. Using a five-point Likert scale, 69 statements were evaluated, with 62 (89.9 %) achieving consensus. This paper aims to establish standardized guidelines to reduce variability and improve predictability in outcomes. For areas where consensus was not reached, ongoing research is essential to address these gaps and advance the management of Behçet’s disease-related uveitis.