Purchase this article with an account.
A.A. Yucel, K. Suner, H. Saricaoglu, B. Kaderli, K. Dilek; Optic Disc Vasculitis in Behçet's Disease . Invest. Ophthalmol. Vis. Sci. 2004;45(13):2701.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose:Optic disc (OD) has not been well studied in Behçet’s Disease (BD).Generally, terms such as "optic neuritis", or "optic neuropathy" imply advanced stages of the OD involvement. The primary lesion of BD is simply a "vasculitis" and theoretically the first step of the optic nerve head involvement should also be a vasculitis.We carried out this study to prove the presence of "optic disc vasculitis"(ODV) as an early stage of eye involvement in BD. Methods:We studied 220 patients with recurrent oral aphthae with at least one or more of the extraocular signs described by the ISGBD or one of the signs (not included in ISGBD classification), the prevalance of which are relatively high in Turkey for BD: HLA–B5 positivity, arthritis/arthralgy, vasculopathy (deep vein thrombosis, trombophlebitis). We performed fundus fluorescein angiography (FA) with digital recording in all patients. Patients with signs of uveitis, retinal vasculitis and patients with other diseases which can cause optic disc edema were excluded. Only eyes with a few "silent" cells in the vitreous and with ophthalmoscopic OD edema grade 0 or more were included. Visual field (VF) testing was not taken into consideration because of the risk of misinterpretation of the VF defects of possible lesions posterior to OD in BD. Results:35 eyes of 20 patients ( mean age: 31.9±9.31) revealed mild, angiographically proven OD edema (11 of 20 patients already had the diagnosis of extraocular BD according to the criteria of ISGBD). Two patterns of OD staining were noted in these eyes: a) diffuse (82.8%) b) segmental or nodular (17.1%). The visual acuity (VA) of the eyes in this group was between 0.8 and 1.0. 32 eyes (91.4%) had the same VA after months of follow–up (mean FU: 18.55±24.16 months). Other visual complaints were transient blurring of vision and photophobia. None of these patients had RAPD. FA of the OD also showed peripapillary vasculitis (8.5%). Few vitreous cells were present in 3 eyes but we also observed the development of the cells in 4 more eyes in 1–4 years to a total of 7 eyes (20%). Conclusions:1) Vague or no visual symptoms, 2) Mild OD edema in all eyes, 3) Persistent good visual acuity, 4) Few cells in the vitreous of some eyes probably indicate a mild but "true" ODV in BD before the formation of uveitis or retinal vasculitis in the eye. This new definition has two important implications of the need to recognize the ophthalmic diagnostic limits of ODV in BD and to develop new strategies with earlier optic nerve head protection.
This PDF is available to Subscribers Only