Changing pattern of clinical manifestations of Behçet's disease in Tunisia: comparison between two decades

Imen Ksiaa; Melek Kechida; Nesrine Abroug; Sabri Bchir; Sonia Attia; Sana Khochtali; Moncef Khairallah

doi:10.5114/reum.2020.95362

Changing pattern of clinical manifestations of Behçet's disease in Tunisia: comparison between two decades

Reumatologia. 2020;58(2):87-92. doi: 10.5114/reum.2020.95362. Epub 2020 Apr 30.

Authors

Imen Ksiaa¹, Melek Kechida², Nesrine Abroug¹, Sabri Bchir², Sonia Attia¹, Sana Khochtali¹, Moncef Khairallah¹

Affiliations

¹ Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Tunisia.
² Department of Internal Medicine and Endocrinology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Tunisia.

Abstract

Objectives: To investigate the changes over time in extraocular and ocular manifestations of Behçet's disease (BD) in Tunisian patients.

Material and methods: Retrospective study of 246 patients divided into two groups: group 1 (147 patients examined from 1995 to 2005) and group 2 (99 patients examined from 2006 to 2017).

Results: Active or scarred genital ulcers observed by physician at presentation were significantly less frequent in group 2 (47.2% vs. 29.6%; p = 0.007), as were articular involvement (50.3% vs. 34.7%; p = 0.016) and erythema nodosum (18.4% vs. 8.1%; p = 0.024). One hundred-seven patients (43.5%) developed ocular manifestations during the 23-year study period. Intermediate uveitis was significantly more frequent in group 2 than in group 1 (11.7% vs. 28.4%; p = 0.003), and posterior uveitis less frequent in group 2 than in group 1 (34.2% vs. 19.7%; p = 0.016). Patients from group 2 were more likely to have macular edema (19.8% vs. 45.6%; p = 0.001). However, better visual prognosis, with a lower rate of legal blindness, was noted in group 2.

Conclusions: Changes over time included a decrease in the rate of articular involvement and cutaneous involvement. There was an increase in the rate of intermediate uveitis and a decrease in the rate of posterior uveitis over time. Despite an increase in the rate of macular edema, there was an improvement in visual prognosis, with less legal blindness over time.

Keywords: Behçet’sdisease; epidemiology; eye; uveitis.