Neuro‐ophthalmological manifestations of Behcet's disease

Purpose Behcet's disease (BD) is an inflammatory disease characterized by recurrent oral aphthous ulcers (major criteria), genital ulcers, uveitis and skin manifestations (minor criteria). Neuro‐ophthalmological manifestations (NOM) are rare. The aim of our study is to report the spectrum of NO...

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Veröffentlicht in:Acta ophthalmologica (Oxford, England) England), 2016-10, Vol.94 (S256), p.n/a
Hauptverfasser: Alghamdi, A., Bodaghi, B., Wechsler, B., Cacoub, P., LeHoang, P., Saadoun, D., Touitou, V.
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container_issue S256
container_start_page
container_title Acta ophthalmologica (Oxford, England)
container_volume 94
creator Alghamdi, A.
Bodaghi, B.
Wechsler, B.
Cacoub, P.
LeHoang, P.
Saadoun, D.
Touitou, V.
description Purpose Behcet's disease (BD) is an inflammatory disease characterized by recurrent oral aphthous ulcers (major criteria), genital ulcers, uveitis and skin manifestations (minor criteria). Neuro‐ophthalmological manifestations (NOM) are rare. The aim of our study is to report the spectrum of NOM of BD, and evaluate their prognosis. Methods Medical records of patients with neuro‐Behcet, seen in a single tertiary center between 1987 and 2015 were retrospectively reviewed. Patients with NOM were included in the study. The diagnosis of neuro‐behcet disease was based on neuro‐imaging and lumbar puncture. All patients were evaluated both in the internal medicine and ophthalmology departments. Results Out of the 217 patients diagnosed with neuro‐BD, 29 presented with NOM. The M/F ratio was 1.2. Mean age at diagnosis was 25.3 years. Clinical NOM included papillitis (27.5%), papilledema (51.7%), retrobulbar optic neuritis (10.3%), optic disc atrophy (31%) and cranial nerve palsy (27.5%). All patients were treated with corticosteroids and immunosuppressive drugs were required in 23 patients. Initially, 79% of patients had a decreased visual acuity, and 79% had visual field defects. After treatment, vision improved or stabilized in 66.7% and worsened in 33.3%. The mean ± SD LogMAR visual acuity improved from 0.4 ± 0.3 at diagnosis to 0.2 ± 0.3 after therapy. 10.3 and 3.4% patients were respectively legally blind at diagnosis and at the end of follow‐up. Conclusions Although NOM of BD are rare, they are potentially severe and disabling. Recognition of NOM is crucial for establishing an early diagnosis. Prompt treatment is the main prognostic factor for the visual outcome for these patients.
doi_str_mv 10.1111/j.1755-3768.2016.0695
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Neuro‐ophthalmological manifestations (NOM) are rare. The aim of our study is to report the spectrum of NOM of BD, and evaluate their prognosis. Methods Medical records of patients with neuro‐Behcet, seen in a single tertiary center between 1987 and 2015 were retrospectively reviewed. Patients with NOM were included in the study. The diagnosis of neuro‐behcet disease was based on neuro‐imaging and lumbar puncture. All patients were evaluated both in the internal medicine and ophthalmology departments. Results Out of the 217 patients diagnosed with neuro‐BD, 29 presented with NOM. The M/F ratio was 1.2. Mean age at diagnosis was 25.3 years. Clinical NOM included papillitis (27.5%), papilledema (51.7%), retrobulbar optic neuritis (10.3%), optic disc atrophy (31%) and cranial nerve palsy (27.5%). All patients were treated with corticosteroids and immunosuppressive drugs were required in 23 patients. Initially, 79% of patients had a decreased visual acuity, and 79% had visual field defects. After treatment, vision improved or stabilized in 66.7% and worsened in 33.3%. The mean ± SD LogMAR visual acuity improved from 0.4 ± 0.3 at diagnosis to 0.2 ± 0.3 after therapy. 10.3 and 3.4% patients were respectively legally blind at diagnosis and at the end of follow‐up. Conclusions Although NOM of BD are rare, they are potentially severe and disabling. Recognition of NOM is crucial for establishing an early diagnosis. Prompt treatment is the main prognostic factor for the visual outcome for these patients.</description><identifier>ISSN: 1755-375X</identifier><identifier>EISSN: 1755-3768</identifier><identifier>DOI: 10.1111/j.1755-3768.2016.0695</identifier><language>eng</language><publisher>Malden: Wiley Subscription Services, Inc</publisher><subject>Acuity ; Atrophy ; Autoimmune diseases ; Behcet's syndrome ; Corticoids ; Corticosteroids ; Criteria ; Immunosuppressive agents ; Intervertebral discs ; Medical records ; Neuritis ; Ophthalmology ; Optic nerve ; Optic neuritis ; Paralysis ; Skin ; Skull ; Swelling ; Ulcers ; Uveitis ; Vein &amp; artery diseases ; Visual acuity ; Visual aspects ; Visual field ; Visual fields</subject><ispartof>Acta ophthalmologica (Oxford, England), 2016-10, Vol.94 (S256), p.n/a</ispartof><rights>Copyright © 2016 Acta Ophthalmologica Scandinavica Foundation</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2525-2511568444553e47dfb8138b5dc2ddd18916659fff637b1afd54d4aab6f238ee3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1755-3768.2016.0695$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27903,27904,45554,46811</link.rule.ids></links><search><creatorcontrib>Alghamdi, A.</creatorcontrib><creatorcontrib>Bodaghi, B.</creatorcontrib><creatorcontrib>Wechsler, B.</creatorcontrib><creatorcontrib>Cacoub, P.</creatorcontrib><creatorcontrib>LeHoang, P.</creatorcontrib><creatorcontrib>Saadoun, D.</creatorcontrib><creatorcontrib>Touitou, V.</creatorcontrib><title>Neuro‐ophthalmological manifestations of Behcet's disease</title><title>Acta ophthalmologica (Oxford, England)</title><description>Purpose Behcet's disease (BD) is an inflammatory disease characterized by recurrent oral aphthous ulcers (major criteria), genital ulcers, uveitis and skin manifestations (minor criteria). Neuro‐ophthalmological manifestations (NOM) are rare. The aim of our study is to report the spectrum of NOM of BD, and evaluate their prognosis. Methods Medical records of patients with neuro‐Behcet, seen in a single tertiary center between 1987 and 2015 were retrospectively reviewed. Patients with NOM were included in the study. The diagnosis of neuro‐behcet disease was based on neuro‐imaging and lumbar puncture. All patients were evaluated both in the internal medicine and ophthalmology departments. Results Out of the 217 patients diagnosed with neuro‐BD, 29 presented with NOM. The M/F ratio was 1.2. Mean age at diagnosis was 25.3 years. Clinical NOM included papillitis (27.5%), papilledema (51.7%), retrobulbar optic neuritis (10.3%), optic disc atrophy (31%) and cranial nerve palsy (27.5%). All patients were treated with corticosteroids and immunosuppressive drugs were required in 23 patients. Initially, 79% of patients had a decreased visual acuity, and 79% had visual field defects. After treatment, vision improved or stabilized in 66.7% and worsened in 33.3%. The mean ± SD LogMAR visual acuity improved from 0.4 ± 0.3 at diagnosis to 0.2 ± 0.3 after therapy. 10.3 and 3.4% patients were respectively legally blind at diagnosis and at the end of follow‐up. Conclusions Although NOM of BD are rare, they are potentially severe and disabling. Recognition of NOM is crucial for establishing an early diagnosis. 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Neuro‐ophthalmological manifestations (NOM) are rare. The aim of our study is to report the spectrum of NOM of BD, and evaluate their prognosis. Methods Medical records of patients with neuro‐Behcet, seen in a single tertiary center between 1987 and 2015 were retrospectively reviewed. Patients with NOM were included in the study. The diagnosis of neuro‐behcet disease was based on neuro‐imaging and lumbar puncture. All patients were evaluated both in the internal medicine and ophthalmology departments. Results Out of the 217 patients diagnosed with neuro‐BD, 29 presented with NOM. The M/F ratio was 1.2. Mean age at diagnosis was 25.3 years. Clinical NOM included papillitis (27.5%), papilledema (51.7%), retrobulbar optic neuritis (10.3%), optic disc atrophy (31%) and cranial nerve palsy (27.5%). All patients were treated with corticosteroids and immunosuppressive drugs were required in 23 patients. Initially, 79% of patients had a decreased visual acuity, and 79% had visual field defects. After treatment, vision improved or stabilized in 66.7% and worsened in 33.3%. The mean ± SD LogMAR visual acuity improved from 0.4 ± 0.3 at diagnosis to 0.2 ± 0.3 after therapy. 10.3 and 3.4% patients were respectively legally blind at diagnosis and at the end of follow‐up. Conclusions Although NOM of BD are rare, they are potentially severe and disabling. Recognition of NOM is crucial for establishing an early diagnosis. Prompt treatment is the main prognostic factor for the visual outcome for these patients.</abstract><cop>Malden</cop><pub>Wiley Subscription Services, Inc</pub><doi>10.1111/j.1755-3768.2016.0695</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record>
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subjects Acuity
Atrophy
Autoimmune diseases
Behcet's syndrome
Corticoids
Corticosteroids
Criteria
Immunosuppressive agents
Intervertebral discs
Medical records
Neuritis
Ophthalmology
Optic nerve
Optic neuritis
Paralysis
Skin
Skull
Swelling
Ulcers
Uveitis
Vein & artery diseases
Visual acuity
Visual aspects
Visual field
Visual fields
title Neuro‐ophthalmological manifestations of Behcet's disease
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