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R. Kacmaz, J. H. Kempen, C. Newcomb, D. A. Jabs, G. A. Levy-Clarke, R. B. Nussenblatt, J. T. Rosenbaum, E. B. Suhler, J. E. Thorne, C. Foster; Clinical Outcomes of Patients With Behcet’s Disease Associated Ocular Inflammation. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5823.
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To estimate the risk of structural ocular complications and visual acuity loss in patients with Behcet’s Disease (BD), to describe the risk factors for developing visual acuity loss and to describe the association between therapy and the incidence of ocular complications and visual acuity loss.
130 patients with BD-associated ocular inflammation evaluated between 1978 and 2007 from the SITE (Systemic Immunosuppressive Therapy for Eye Diseases) cohort study database were included. Clinical data on these patients were collected retrospectively and analyzed using longitudinal data analysis techniques. Outcome measures were the development of structural ocular complications and loss of visual acuity loss to the 20/50 or worse and 20/200 or worse thresholds.
The incidence rate of any ocular complication was 0.40/eye-year (EY). Rates of loss of visual acuity to 20/50 or worse and to 20/200 or worse were 0.12/EY and 0.10/EY respectively. Risk factors for visual acuity loss during follow-up were the persistence of intraocular inflammation activity, presence of posterior synechiae, presence of retinal vasculitis, presence of hypotony, and presence of elevated intraocular pressure (IOP). Activity of ocular inflammation during follow-up was associated with an increased risk of 20/200 or worse vision (RR=2.96, p=0.0218). Corticosteroid and immunosuppressive therapy reduced the risk of vision loss to 20/200 or worse by 32% and 18% respectively.
Loss of visual acuity and occurrence of ocular complications were common in patients with BD despite typically aggressive therapy. Active inflammation during follow-up, presence of posterior synechiae, and retinal vasculitis were associated with increased risk of loss of visual acuity. Immunosuppressive and corticosteroid therapy reduced the risk of some complications in affected eyes.
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