Neuro-ophthalmological manifestations of Behçet's disease. Issue 1 (26th April 2018)

• Record Type: Journal Article
• Authors: Alghamdi, Ammr; Bodaghi, Bahram; Comarmond, Chloé; Desbois, Anne Claire; Domont, Fanny; Wechsler, Bertrand; Depaz, Raphael; Le Hoang, Phuc; Cacoub, Patrice; Touitou, Valérie; Saadoun, David
• Is Part Of: British journal of ophthalmology. Volume 103:Issue 1(2019)
• Page Start: 83
• Page End: 87
• Publication Date: 2018-04-26
• Subjects: optic erve -- inflammation -- imaging -- immunology; Ophthalmology -- Periodicals; 617.7
• DOI: 10.1136/bjophthalmol-2017-311334
• Languages: English
• ISSNs: 0007-1161

Abstract

Abstract : Background: The neuro-ophthalmological manifestations of Behcet's disease (BD) are rare, and data regarding their characteristics and outcome are lacking. Objective: To report prevalence, main characteristics and outcome of neuro-ophthalmological manifestations in BD. Patients and methods: This is a retrospective monocentric study of 217 patients diagnosed with neuro-Behçet's disease (NBD), of whom 29 (13.3%) patients presented with neuro-ophthalmological manifestations (55% of men and mean±SD age of 26±8 years). All patients underwent a detailed ophthalmological examination and were followed up in the internal medicine and the ophthalmology departments. Results: Neuro-ophthalmological manifestations were the first presentation of BD in 45% of patients and developed later in the course of the disease in 55% of patients. They are divided into parenchymal (PM) and non-parenchymal (NPM)-related manifestations in, respectively, 13 patients (45%) and 16 patients (55%). PM included papillitis in seven patients (53.8%), retrobulbar optic neuritis in four patients (30.8%) and third cranial nerve palsy in two patients (15.4%). NPM included papilloedema related to cerebral venous thrombosis in all 16 patients, of whom 6 patients (37.5%) had sixth cranial nerve palsy. At initial examination, 93.1% of patients had visual alterations, including mainly decreased visual acuity visual field defects and/or diplopia. All patients were treated with corticosteroids and 79% of patients received immunosuppressive agents. After treatment, the visual outcome improved or stabilised in 66.7% of patients while it worsened in 33.3. The mean±SD logarithm of the minimum angle of resolution visual acuity improved from 0.4±0.3 at diagnosis to 0.2±0.3 after therapy. 10.3% and 3.4% of patients were legally blind at diagnosis and after therapy, respectively. Conclusion: Neuro-ophthalmological manifestations of BD represented 13% of NBD. They could be potentially severe and disabling. Prompt treatment is the key factor in improving visual outcome.