Behcet's disease (BD) is a chronic, relapsing, multisystem disease. In some patients, ocular involvement can lead to severe vision impairment despite immunosuppressive therapy. Since high levels of circulating TNF-alpha have been found both in peripheral blood and aqueous humor of patients with active BD, we evaluated the efficacy of anti-TNF-alpha therapy in seven patients with severe ocular involvement resistant to previous treatment. Seven patients with sight-threatening relapsing uveitis refractory to immunosuppressive regimens received intravenously infliximab, at a dose of 3-5 mg/kg, on week 0-2-4 and then every 6-8 weeks, in combination with low-dose prednisone and methotrexate or azathioprine. Efficacy was assessed in terms of number and severity of relapses of posterior uveitis, visual acuity, and reduction of corticosteroids and immunosuppressive drugs. After a mean follow-up period of 23 months, the total number of relapses dropped to 6, compared to the 21 observed in an equivalent period of time before treatment. The visual acuity improved in 4 eyes, while it remained stable in 9. Therapy with infliximab considerably reduced the required daily dose of both corticosteroids and immunosuppressive drugs. In our experience infliximab proved to be safe and effective in controlling both the number and intensity of cases of posterior uveitis and the extraocular manifestations of BD. It also allowed a reduction of corticosteroids and immunosuppressive drugs required to control the disease. However, ocular and systemic manifestations tended to recur after drug withdrawal or when the interval between infliximab courses was longer than 8 weeks. Moreover, infliximab administration is costly and requires hospital admission.

No abstract

No abstract

TB of the eye should not be forgotten, even in geographical areas not considered among endemic countries. Ocular evaluation is advisable in patients with pulmonary and extrapulmonary TB, as early detection may allow ATT to preserve visual acuity.

Dif fercrizianiento microgeografico eti ecolugico in IIotrj.1lii.s schlosscri (Ascidiacca). * (Coil 1 tav. a colori 1. le3lo) Bofryllns -sdrlosscri (Pallns) Sii\igri), asritli;i rolonialc, 6 iitia spccic ail aiiipia tlistril)iizinnc gcngraficn, clirfiisa ncllc rcgioni artica, nortlatlantica c iiicilitcrrancn. Lc colonic vivono iii acc~iic poco profontlc tlcllii zniia IitoraIc, nclla fascia intcrcotitlitlc n i n qiiclln iiiiiiictlialaiiicnlc rctrostantc. c o i l prcFcI~iizn Iicr Ic acqiic Iiortiinli ; 5 i ind i a n n sii 1)ancIiitic c ImiItiIi n sill Fontlo, Iicr lo piii iiicrostatc sit n~p~i e , ccspiigIi tIi Iir'iozoi, concliiplic tIi rnoIIiiscIii, foglie tIi Zostcrii Qitcs~n slwcic prcrcrila oviinqiic i i n iiltn firatlo t l i poliiiiorfisiiio : riirrilrc gli snnitli cli rin.wiirin cnloiiiii Iiannn la stcssn pipiiiciitnzinne. Ic rolonic Iiosniio tlilfcrirc Trn loro sill p c r la qiinliti tlci pigiiiciiti? :ia iicr i tipi di discgiii ciii 11; Iiiogn la divcrsa tlistril~iizioiic tlcllc ccllulc pipiiciilatc.