Uveitis in Behçet disease - An update


Tugal-Tutkun I.

Current Opinion in Rheumatology, vol.35, no.1, pp.17-24, 2023 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Review
  • Volume: 35 Issue: 1
  • Publication Date: 2023
  • Doi Number: 10.1097/bor.0000000000000911
  • Journal Name: Current Opinion in Rheumatology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
  • Page Numbers: pp.17-24
  • Keywords: anti-tumor necrosis factor alpha, Behçet disease uveitis, fluorescein angiography, interferon-α, optical coherence tomography
  • Istanbul University Affiliated: Yes

Abstract

© 2023 Lippincott Williams and Wilkins. All rights reserved.Purpose of reviewUveitis is a major manifestation of Behçet disease (BD) and potentially has a high morbidity. This article reviews recently published data on BD uveitis.Recent findingsA set of classification criteria and a diagnostic algorithm have been developed for BD uveitis. Recent reports have confirmed male predominance and posterior segment inflammation in the majority of BD uveitis patients. A high uveitis attack severity score, fluorescein angiographic leakage at the posterior pole, and disruption of outer retinal layers on optical coherence tomography (OCT) predict poor visual outcome. OCT-angiography studies have suggested subclinical changes of retinal capillaries in patients with or without ocular involvement. In a randomized controlled trial, interferon-α was superior to cyclosporine. Favorable outcomes were reported with earlier initiation, optimization, and withdrawal of infliximab after remission. Adalimumab as first-line was superior to conventional therapy.SummaryClassification criteria will be used to select a homogeneous group of patients for research and the diagnostic algorithm may help ophthalmologists predict the probability of BD uveitis based on ocular findings. Fluorescein angiography and OCT are the routine imaging modalities. Clinical relevance of OCT-angiography is unclear. Interferon-α, infliximab, and adalimumab have proven superior efficacy compared to conventional therapy.