Abstract
Abstract: :
Purpose: To analyze differences in response to treatment of ocular Adamantiades–Behcet’s disease (ABD) in the 1970’s, 1980’s and 1990’s. Methods: Medical records of thirty six randomly selected patients with uveitis due to Adamantiades–Behcet’s disease followed at the National Eye Institute (NEI) were reviewed. Results: All the patients were divided into 3 groups according to the time of follow–up: first group was followed from 1962 to 1972, second group from 1983 to 1992 and the third group from 1992 through 2004. Visual acuities and degrees of inflammation in each group were recorded at each visit. There were 12 patients (24 affected eyes) in the 1970’s group, 7 patients (14 eyes) in the 1980’s group and 17 patients (34 eyes) in the most recent group. Mean follow–up in the 1970’s group was 3.06 years, in the 1980’s – 4.68 years and in the most recent group– 4.03 years. Mean time between the diagnosis of ABD and presentation to NEI was 3.8 years in the 1970’s group, 3 years in the 1980’s group and 4.4 years in the most recent group. Therapeutic agents used in the 1970’s group included systemic steroids, methotrexate, 6–mercaptopurine, azathioprine, cyclophosphamide and chlorambucil. Agents used in the 1980’s group included systemic steroids, cyclosporine, chlorambucil and colchicine. Medications used in the most recent group included systemic steroids, cyclosporine, azathioprine, daclizumab, mycophenolate mofetil, methotrexate and infliximab. Statistical analysis showed that the average logMAR changes per year were: 0.6479 in the 1970’s group, –0.0225 in 1980’s group and –0.0272 in the most recent group. Conclusions: Adamantiades–Behcet’s disease is a severe blinding disorder. Our data shows a trend for clinical improvement from the1970’s to 1990’s, although the changes in visual outcomes did not reach statistical significance. Larger studies may be more empowered to demonstrate the trend for improvement due to introduction of newer agents and directed therapy.
Keywords: inflammation • immunomodulation/immunoregulation • uveitis-clinical/animal model