Abstract
Purpose::
We evaluated visual prognosis of Behcet uveitis in Korean patients and associated factors for poor visual outcomes. We also compared disease stabilities according to treatment modalities.
Methods::
A retrospective analysis was done on 99 consecutive patients (168 eyes) with Behcet uveitis. An average follow up period was 4.76 years (0.8-10), and all patients were in accordance with the criteria of International Study Group for Behcet’s disease. Visual prognosis of Behcet uveitis patients was evaluated with Kaplan-Meier survival curve, and risk factors were identified using Cox’s proportional hazard regression analysis. Recurrence free intervals among different treatment modalities were analyzed using ANOVA and t-test.
Results::
Male was 57 with 94 eyes (56%), female, 42 with 74 eyes (44%), and average onset age was 36.0 (11-64). 30 patients (30.3%) were unilateral and 69 (69.7%) patients were bilateral. 39 eyes (23.2%) involved anterior segments only, and 26 eyes (15.5%) were posterior type, while other 103 eyes (61.3%) were panuveitis. At the beginning of the follow-up, potential visual acuity was less than 0.1 in 34 eyes (20.2%). Kaplan-Meier survival analysis estimated the risks of losing useful vision (>0.1) at 5 and 10 years for Behcet uveitis patients to be 16.6% and 20.5% respectively. Visual acuity at first visit (<0.5), the presence of vasculitis, male, and posterior/panuveitis type were influential factors for poor visual prognosis of Behcet uveitis in survival curve. Cox’s proportional hazard regression analysis revealed that the visual acuity at first visit (hazard ratio=7.392, p=0.007) was the most significant risk factor for poor visual outcome. Analysis of 9 different treatment modalities on maintenance period without attack revealed statistically significant difference (p=0.006,ANOVA) and treatment modality including steroid had longer duration of recurrence free periods compared to other treatments without steroid(p=0.0033,t-test).
Conclusions::
Long term visual prognosis of Behcet uveitis may be affected by many factors, and visual acuity at the first visit appears to be the most important factor. Treatment modality including steroid seems to be effective in decreasing attack frequency.
Keywords: uveitis-clinical/animal model • clinical (human) or epidemiologic studies: risk factor assessment • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials