Behcet's Disease

Behcet’s disease was initially described by Behcet in 1937 as a triad of oral ulcers, genital ulcers, and hypopyon uveitis. The most common ocular manifestations are ididocyclitis with or without a hypopyon and retinal vasculitis. Ocular inflammations have occurred in countries along the Mediterranean Sea to Japan and are of unknown etiology. Conjunctivitis, keratitis, and scleritis occasionally have been described, but are far less common. In addition, neuro-ophthalmic lesions due to the vascular involvement include cranial nerve palsies, papilledema, and ischemic optic neuropathy, the characteristic posterior segment lesion is retinal vasculitis, which may include both veins and arteries.

Early lesions show a few round cells on the retina, chroroids, and chamber angle. The eye can become legally blind (20/200) with lots of pain, glaucoma, rubeosis, and possibly a retinal detachment generally within about 5 years.

Immunosuppressive drugs have been proven to be the most effective treatment in slowing down the progression of Behcet’s disease. Oral steroids have also had some success in the treatment area. Consideration should be given to having a rheumatology consultation conducted, HLA-B51, HLA-B27, and HLA-B5 labs performed. Lower doses of cyclosporine are now used in conjunction with systemic steroids.