Abstract
Purpose To examine and spot systemic findings commonly associated with a serious form of ocular Behcet's disease. This could potentially help ophthalmologists categorize their patients based on future risk and plan treatment accordingly. Subjects and Methods The data of 249 patients with Behcet's disease were examined thoroughly. Correlations between systemic and ocular findings were recorded. Patients were further subgrouped by the authors as having a vision-threatening form of the disease or not. Regression analysis was done to spot predictors for a vision-threatening form of the disease. Results The presence of systemic vasculitis and oral and genital ulcers in a patient with Behcet's disease was found to be associated with a milder form of ocular affection or none at all and vice versa. Certain correlations between findings were also found. Conclusion Certain findings in Behcet's disease may act as predictors for the severity of ocular affection. Directing our attention to these factors by the internist and ophthalmologist can help plan the frequency of follow-up as well as the aggressiveness of treatment in patients with Behcet's disease.
Highlights
Behcet’s disease (BD) is a chronic, relapsing, inflammatory vascular disease of unknown etiology that commonly affects the eye with unpredictable exacerbations and remissions
Two of the most commonly used classification criteria are the ICBD (International Criteria for Behcet’s Disease) which was used in this study and the ISG (International Study Group) criteria
Performance of the ISG, ICBD 2006, revised Japanese criteria, and the revised ICBD 2010 was evaluated in terms of sensitivity, specificity, negative likelihood ratio (NLR), negative predictive value (NPV), positive predictive value (PPV), positive likelihood ratio (PLR), diagnostic odds ratio (DOR), and Youden’s index (YI), and it was found that the ICBD 2010 carried the highest sensitivity (98.83%), NPV (98.48%), DOR (1645), and YI (0.94) and the lowest NLR (0.01) [4]
Summary
Behcet’s disease (BD) is a chronic, relapsing, inflammatory vascular disease of unknown etiology that commonly affects the eye with unpredictable exacerbations and remissions. A 4-year follow-up study done on Egyptian patients with Behcet’s disease demonstrated a higher male-to-female ratio and a higher incidence of neurological (34.9%) and vascular (57.1%) lesions than other countries. Another study done in Cairo University, Egypt, found that the ICBD criteria perform better on Egyptian patients more than other available classifications [4]. Complications like retinal detachment, secondary glaucoma, and optic atrophy often cause irreversible visual loss. It is very important for an ophthalmologist to be able to predict which case of Behcet’s disease will. The authors further pursued this point of research in an attempt to look for clinical predictors for the potentially vision-threatening form of Behcet’s disease. In the hope that this can allow ophthalmologists and internists to take appropriate measures in a timely fashion, it was for this purpose that this work was done
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