Visual Prognosis and Risk Factors for Korean Patients with Behcet Uveitis

Abstract

Purpose: Visual prognosis was evaluated in Korean Behcet uveitis patients. The study investigated factors associated with poor visual outcome, and the effect of various treatments on recurrence-free duration. Methods: A retrospective analysis was undertaken on 99 consecutive Behcet uveitis patients (168 eyes). Visual prognosis was evaluated using Kaplan-Meier survival curves, and Cox’s proportional hazard regression analysis was used to identify risk factors. Results: Visual acuity at the first visit (<0.5), presence of vasculitis, male gender, and posterior/panuveitis type were associated with poor visual prognosis. Visual acuity at the first visit was found to be the most significant risk factor (hazard ratio = 7.392, p = 0.007). Analysis of 9 different treatment modalities showed patients treated with steroids had longer recurrence-free periods than those not treated with steroids (p = 0.0053, t test). Conclusion: Whilethe long-term visual prognosis for Behcet uveitis may be affected by many factors, the initial visual acuity appears to be the most significant. Treatments involving steroids appear to decrease the frequency of uveitis recurrence.

Outcome Measures Used in Clinical Trials for Behçet Syndrome: A Systematic Review

“…However, the definition of an inflammatory flare varied widely among studies, and visual acuity was reported in several different ways, including change on Snellen chart or Japanese standard Landolt visual acuity chart, calculating the LogMar (logarithm of the minimum angle of resolution), or the percentage of patients who had a certain level of improvement. Loss of useful vision is another similar outcome used 99,160,163,167,174,175,176,177 . Different components of the Standardization of Uveitis Nomenclature Working Group Criteria, a generic uveitis measure, were used in some of the trials for BS 14-16,146,150,154,176 .…”

Correlation between Fluorescein Angiographic Findings and Visual Acuity in Behçet Retinal Vasculitis

“… 2 Among many ocular manifestations, retinal vasculitis has been reported to be one of the most common ocular findings and suggested to be significantly correlated with visual prognosis in many studies. 3 4 5 As chronic and recurrent inflammation of retinal vessels is of major concern in Behçet retinal vasculitis due to the cumulative damage it causes to retinal structures, 6 the identification of specific angiographic findings of such pathology and their association with visual acuity (VA) bear clinical significance.…”

Ocular Involvement

“…Many reports have been published about the factors for poor visual prognoses in BD, such as male gender [ 7 , 17 , 18 , 20 , 35 ], young age [ 36 ], higher frequency of ocular attacks [ 33 , 37 ], chorioretinitis type [ 7 , 20 ], presence of skin lesions and/or arthritis [ 20 ], central nervous system involvement [ 20 , 36 ], vascular thrombosis [ 36 ], strong vitreous opacity and exudates within the retinal arcade [ 37 ], current active intraocular infl ammation [ 38 ], unilateral disease [ 35 ], disc neovascularization [ 25 ], presence of macular ischemia on fl uorescein angiography [ 25 ], poor visual acuity at the initial visit [ 39 ], and HLA-A26 positivity [ 40 ]. On the other hand, female gender [ 7 , 17 , 18 , 20 , 35 ], anterior uveitis type [ 7 , 20 ], and the use of biological agents (antitumor necrosis factor (TNF)-α) [ 35 ] have been found to be related to retention of vision.…”