Abstract
Purpose: :
To evaluate the role of pars plana vitrectomy (PPV) for the treatment of vitreoretinal complications of ocular Behçet’s disease (BD).
Methods: :
Retrospective review of the medical records of all patients who underwent PPV for vitreo-retinal complications of ocular BD in the Ophthalmology Department of the Hospital Clinic of Barcelona, from 1994 until 2011. Preoperative and postoperative best corrected visual acuities (BCVA), ocular findings, ocular and systemic treatments, surgical indications, and outcomes were evaluated in all patients.
Results: :
Twelve patients (14 eyes) were included in the study. Indications for PPV were the following: vitreous haemorrhage in 5 eyes (35.7%), retinal detachment in 3 eyes (21.4%), persistent vitreous opacities in 3 eyes (21.4%), macular hole in 2 eyes (14.3%) and persistent macular edema in 2 eyes (14.3%). At last examination (mean follow up, 105 months), BCVA increased 2 Snellen lines or more in 12 eyes (86%). No patients presented a worsening in visual acuity. In the postoperative follow-up, posterior subcapular cataract development was observed in 3 eyes (25%). Systemic immunosuppressive treatment could be reduced in 5 patients (41.6%). No serious ocular inflammatory relapses presented during the follow-up in those operated patients.
Conclusions: :
This retrospective series with long-term follow-up highlights the potential of surgery to restore anatomy and/or clear opacified media to improve visual outcome in Behçet patients. In addition, PPV may reduce the number of inflammatory relapses and, in consequence, the need of systemic immunomodulatory therapy in selected cases. Aggressive perioperative medical treatment is mandatory to minimize surgery-induced exacerbations of uveitis.
Keywords: vitreoretinal surgery • uveitis-clinical/animal model • autoimmune disease