Macular structural changes and factors affecting final visual acuity in patients with Behçet uveitis

Yalçındağ, F Nilüfer; Temel, Emine; Şekkeli, Mehmet Zahid; Kar, İrem

doi:10.1007/s00417-020-04958-4

Cited by 7 publications

(3 citation statements)

References 21 publications

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“…Vitreal flow, which is a sign of spillover cells from the anterior chamber determining vitreal inflammation, was detected. Optical coherence tomography (OCT) performed with spectral domain OCT (SD-OCT) (Heidelberg Engineering, Heidelberg, Germany) [ 10 ] showed normal macular thickness (mean macular thickness [MMT] 230 μm, normal range 212±20 μm) with no retinal pigment epithelium (RPE) dystrophy, and an inflammatory cell flow in the vitreous.…”

Section: Case Reportmentioning

confidence: 99%

Probiotic Supplementation Improved Acute Anterior Uveitis of 3-Year Duration: A Case Report

et al. 2021

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Patient: Female, 18-year-old Final Diagnosis: Autoimmune uveitis Symptoms: Anterior phlogosis • recurrent eye redness Medication: — Clinical Procedure: Best-corrected visual acuity • fundus examination • intraocular pressure measurment • slit lamp examination • spectral domain OCT (SD-OCT) Specialty: Ophthalmology Objective: Unusual setting of medical care Background: Uveitis is a clinical condition characterized by acute blurry vision related to an inflammation of the uvea. Gut microbiome dysbiosis can influence the prognosis of uveitis by inducing a loss of intestinal immune homeostasis leading to a lower activation threshold of the immune cells. This promotes a pro-inflammatory response resulting in reactivation of the disease. This is the case report of a 21-year-old woman with a 3-year history of acute anterior uveitis (AAU) of the right eye, who responded favorably to probiotic dietary supplementation. Case Report: A 21-year-old woman, previously unknown to our Ophthalmology Unit, presented with ocular pain and redness. Three years ago, she had been diagnosed with monolateral AAU in the right eye. Her medical and family histories were unremarkable. After a complete clinical evaluation, we decided to start a combination treatment protocol with continuous use of probiotics and the use of ocular steroids only during an exacerbation of the condition. To monitor the trend of the disease, she underwent a monthly clinical examination for the following year. During this period, we observed a decrease in ocular inflammation with a gain in the primary outcome (best-corrected visual acuity), and the steroids and atropine were discontinued for the following months. Conclusions: This case report describes a patient with a 3-year history of AAU, who responded well to a combination treatment of dietary probiotic supplementation and steroids, demonstrating that probiotics can reduce recurrences of AAU.

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Section: Case Reportmentioning

confidence: 99%

Probiotic Supplementation Improved Acute Anterior Uveitis of 3-Year Duration: A Case Report

et al. 2021

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“…Optical coherence tomography (OCT) is a noninvasive imaging modality that allows qualitative and quantitative assessment of macular changes, especially macular edema, in BD uveitis [27,30]. Yalcindag et al [30] have reported that the disruption of the ellipsoid zone, a hyper-reflective band relevant to photoreceptor integrity, and loss of normal foveal contour on macular OCT imaging during active inflammation could predict lower final visual acuity. In fact, macular cone abnormalities were found in a small group of BD patients with or without a history of uveitis in a recent study using adaptive optics scanning light ophthalmoscope [31].…”

Section: Assessment Of Disease Activity and Imaging Studies In Behc ¸...mentioning

confidence: 99%

Uveitis in Behçet disease - an update

Tuğal-Tutkun

2022

Current Opinion in Rheumatology

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Purpose of reviewUveitis is a major manifestation of Behc ¸et 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-a 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-a, infliximab, and adalimumab have proven superior efficacy compared to conventional therapy.

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“…15 Both the inner and outer retina, including photoreceptors, are damaged in patients with BD, and deteriorating visual acuity is associated with disruption of the ellipsoid zone (EZ). 16 To date, there has been no reported study about the changes over time in macular OCT in patients with BD. Therefore, the purpose of this study was to retrospectively describe the morphologic changes in macular OCT in patients with BD, to evaluate the relationship of these changes with visual acuity, and to find the effect of treatment on these changes.…”

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confidence: 99%

Optical coherence tomography characteristics over time in Behçet's uveitis

Liang

Zeng

et al. 2023

Retina

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Purpose: To analyze the characteristics of macular optical coherence tomography in patients with Behçet's uveitis (BU). Methods: Retrospectively analyzing optical coherence tomography images and clinical data of patients with Behçet's uveitis who visited our hospital from January 2010 to July 2022. Results: One hundred and one patients (174 eyes) were included. We analyzed the development of optical coherence tomography changes in these patients and its relationship with acuity vision and found that cystic macular edema, hyperreflexive retinal spots, inner nuclear layer edema, and outer nuclear layer edema appeared at any time during the disease course. Epiretinal membranes appeared beginning 1 to 2 weeks after onset and worsened over time, and foveal atrophy occurred beginning at 2 to 4 weeks. Foveal atrophy, foveal layers disappear, ellipsoid zone (EZ) disruption, retinal pigment epithelium (RPE) disruption, RPE hyperreflection, and choroidal hyperreflection were correlated with visual acuity. Kaplan‒Meier survival analysis showed at 60 months of follow-up, and almost all patients with foveal atrophy, EZ disruption, RPE disruption, RPE hyperreflection, and choroidal hyperreflection had visual acuity less than logMAR 1.0. EZ disruption and RPE disruption were reversible with aggressive treatment from 4 to 12 months after onset, but was less recoverable after 2 years. In advanced stages, optical coherence tomography manifested as structural disturbances and atrophy of the macular area, highly reflective material deposition in the RPE layer, and a thick macular epimembrane. Conclusion: Optical coherence tomography showed that severe lesions occurred in macula of patients with Behçet's uveitis in early stage. Aggressive treatment can partially reverse it.

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Macular structural changes and factors affecting final visual acuity in patients with Behçet uveitis

Cited by 7 publications

References 21 publications

Probiotic Supplementation Improved Acute Anterior Uveitis of 3-Year Duration: A Case Report

Probiotic Supplementation Improved Acute Anterior Uveitis of 3-Year Duration: A Case Report

Uveitis in Behçet disease - an update

Optical coherence tomography characteristics over time in Behçet's uveitis

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