Uveitis in Behçet disease - an update

Curr Opin Rheumatol. 2023 Jan 1;35(1):17-24. doi: 10.1097/BOR.0000000000000911. Epub 2022 Oct 14.

Abstract

Purpose of review: Uveitis is a major manifestation of Behçet disease (BD) and potentially has a high morbidity. This article reviews recently published data on BD uveitis.

Recent findings: A 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.

Summary: Classification 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.

Publication types

  • Review

MeSH terms

  • Adalimumab / therapeutic use
  • Behcet Syndrome* / diagnosis
  • Behcet Syndrome* / diagnostic imaging
  • Female
  • Fluorescein Angiography
  • Humans
  • Infliximab / therapeutic use
  • Interferon-alpha
  • Male
  • Randomized Controlled Trials as Topic
  • Tomography, Optical Coherence / methods
  • Uveitis* / drug therapy

Substances

  • Infliximab
  • Adalimumab
  • Interferon-alpha