Onset Of Uveitis Research Articles

Local therapy for cancer therapy-associated uveitis: a case series and review of the literature

Background/aimsImmunotherapy and targeted therapy for metastatic cancer may cause immune-related adverse events (irAEs) such as uveitis. If irAEs are severe or require systemic steroids, cancer therapy is often held or...

Comparison of the Treatment Results for Behçet Uveitis in Patients Treated with Infliximab and Interferon

ABSTRACTPurpose: To compare the efficacy and safety of infliximab and interferon in patients with refractory Behçet uveitis.Methods: Medical records of 20 patients treated with infliximab (IFX) and 33 patients treated with interferon (IFN) were retrospectively analyzed by evaluating the number of uveitis attacks, visual acuity and ocular inflammation at 6 and 12 months after initiation of treatment.Results: Mean duration of treatment was 22 ± 18 months in IFX group and 30.3 ± 22.5 months in IFN group. Sixteen patients of IFX group (80%) and 28 patients of IFN group (85%) achieved remission. In both groups, the mean best-corrected visual acuity and all inflammatory parameters improved. In terms of these parameters, there was no significant difference between the two groups.Conclusion: Infliximab and interferon improve control of ocular inflammation and efficiently decrease the relapse rate. Our results determined no significant difference between two agents in controlling intraocular inflammation.

New onset or exacerbation of uveitis with infliximab: paradoxical effects?

ObjectiveTo report four cases of new onset or exacerbation of uveitis following administration of infliximab.MethodsThis retrospective observational case series includes four patients who developed new onset or exacerbation of uveitis...

Ultrasonographic Enthesis Evaluation in Patients with Recurrent Acute Anterior Uveitis with and without Spondyloarthropathy

Background: spondyloarthritis (SpA) is a group of chronic diseases recognized by arthritis and extraarticular lesions e.g. uveitis, enthesitis, dermatological affection. About 35% of SpA patients may present with recurrent attacks of acute anterior uveitis (AAU). Purpose: it was to detect whether patients with idiopathic recurrent AAU who were positive or negative for Human Leukocyte Antigen B27 (HLA–B27) had a frequency of enthesis lesions compared to that seen in patients with SpA. Patients and Methods: a prospective study of enthesis evident on musculoskeletal ultrasound examination was done on sixty patients and twenty controls, the eighty were categorized into 4 groups; group 1 included 20 patients with known SpA group 2 included 20 with recurrent AAU HLA–B27 positive and didn’t have SpA aspects group 3 included 20 with recurrent AAU HLA–B27 negative and didn’t have SpA and group 4 included 20 healthy controls. Using Madrid Sonography Enthesitis Index (MASEI) twelve enthesis locations were assessed in each participant. Results: a total of 960 entheses sites were examined by ultrasonography in all 80 participants. The MASEI cut-off limit of ≥18 points was 75%, 60%, 45%, and 10% of the participants in the 4 groups; respectively. The MASEI score was significantly higher in groups 1&2 than in groups 3&4. The differences between the two groups were statistically significant. Conclusion: a high percent of HLA–B27 positive patients with idiopathic recurrent AAU without characteristics of SpA have enthesis lesions with about percent to those seen in patients with known SpA.

Inhibitory role of transforming growth factor \u03b22 in experimental autoimmune anterior uveitis

PurposeExperimental autoimmune anterior uveitis (EAAU) is a clinically relevant animal model for human idiopathic anterior uveitis (IAU). The role of the immunomodulator transforming growth factor β2 (TGF-β2) in EAAU pathology is unknown. In this study, we investigated the regulatory role of TGF-β2 in EAAU.MethodsEAAU was induced in male Lewis rats by footpad injection of melanin-associated antigen (MAA). TGF-β2 was administered intravenously (iv) in MAA-sensitized rats during the induction of EAAU, or after the clinical onset of uveitis. MAA-sensitized rats injected similarly with an equal volume of PBS served as control. Animals were examined daily between days 7 and 30 post-injection for the clinical signs of uveitis using slit lamp biomicroscopy. Animals were sacrificed at various time points and eyes were harvested for histological analysis to assess the course and severity of inflammation. For histopathological analysis, paraffin sections of harvested eyes were stained with hematoxylin and eosin. Popliteal lymph nodes (LNs) were used for CD4+CD25+FoxP3+ T regulatory (Tregs) population analysis and for CD4+ T cell proliferation assay.ResultsAdministration of recombinant TGF-β2 during the early stages of EAAU prevented the induction of uveitis. Compared to PBS, the presence of TGF-β2 in the cell culture significantly (p < 0.05) inhibited the proliferation of CD4+ T cells in response to MAA. In MAA-sensitized Lewis rats, iv treatment with recombinant TGF-β2 resulted in significantly (p < 0.05) increased percentage of Tregs compared to animals treated similarly with PBS. Thus, TGF-β2 inhibited the induction of EAAU by inhibiting CD4+ T cell proliferation and increasing the number of Tregs. Injection of TGF-β2 in rats with active EAAU resulted in diminished disease activity. Unfortunately, this treatment did not lead to the early resolution of EAAU.ConclusionsTGF-β2 plays a critical role in regulation of intraocular inflammation in EAAU. Findings reported in this study improve our understanding of immunopathology of IAU and suggest that recombinant TGF-β2 may be a promising therapeutic agent for human IAU.

Etiological and Clinical Characteristics of HLA-B27-associated Uveitis in a Tertiary Referral Center

Objectives:To investigate the demographic, etiologic, and clinical features of HLA-B27-associated uveitis.Materials and Methods:The clinical records of 91 patients diagnosed with HLA-B27-associated uveitis at the Ulucanlar Eye Training and Research Hospital between the years of 2005 and 2016 were reviewed. Each patient’s presenting complaints, best-corrected visual acuities in first and last visits, biomicroscopic and fundoscopic examination findings, frequency and seasonal distribution of attacks, and demographic data such as age and sex were noted. Therapeutic approaches, duration of follow-up, and complications were analyzed.Results:A total of 91 patients (179 eyes) aged 19-82 years (mean age 46.52±13.06 years) were included. Forty-three patients (47.3%) were female and 48 (52.7%) were male. Bilateral involvement was observed in 44 (48.4%) and unilateral involvement was observed in 47 (51.6%) patients. The most frequent complaint was redness (67%), followed by decreased and/or blurred vision (50.5%). The mean follow-up time was 38.2 months (range, 1-245 months). Anterior uveitis was most common anatomical subtype, seen in 86 (94.5%) of the patients. Mean number of attacks was 1.93±1.45 per patient-year and a significantly higher number of uveitis attacks (47%) occurred in winter. Twenty-four patients (26.3%) were diagnosed with ankylosing spondylitis. Fibrinous uveitis was detected in 36 patients (39.5%). Posterior synechia developed in 41 (22.9%) and hypopyon developed in 7 (3.9%) eyes. The most common complications were cataract (n=12, 6.7%) and ocular hypertension (n=15, 8.3%).Conclusion:Ninety-one (6.3%) of the 1422 patients followed in our uvea clinic were diagnosed with HLA-B27-associated uveitis. HLA-B27-associated uveitis is characterized by acute, recurring sudden-onset iridocyclitis with a moderate to severe amount of fibrin and cells in the anterior chamber, and is easily treatable. Visual prognosis is good despite the complications.

Uveitis manifestations in patients of the Swiss Inflammatory Bowel Disease Cohort Study

Background:The knowledge about risk factors for the onset of uveitis manifestations in patients with inflammatory bowel disease (IBD) is still limited. Here, we aimed to provide an overview of the clinical factors associated with the onset of uveitis in the Swiss IBD Cohort Study (SIBDCS).Methods:We included epidemiological and clinical data from 1840 patients with Crohn’s disease (CD) and 1426 patients with ulcerative colitis (UC) followed up in the SIBDCS between 2006 and 2018. Associations between disease characteristics and uveitis were assessed in univariate and multivariate analyses.Results:Overall, we identified 285 patients with uveitis. Uveitis was more frequent in patients with CD (11.1%; 205 of 1635) than UC (5.6%; 80 of 1346; odds ratio 2.11, p < 0.001). The occurrence of uveitis manifestations in patients with UC and CD was significantly associated with the onset of other extraintestinal manifestations, also in multivariate analyses. The onset of uveitis was associated with the hallmark features of severe disease in both CD and UC, including a higher clinical disease activity index and the use of immunomodulators or calcineurin inhibitors. In CD, uveitis was more frequent in females and showed a positive correlation with a positive family history of IBD.Conclusions:Our data demonstrate that uveitis in IBD occurs more often in CD as well as in women and is associated with a more severe disease course. This might guide physicians’ awareness in at-risk patients to the presence of uveitis extraintestinal manifestations and help to improve patient care.

Patterns of uveitis at a tertiary care hospital in Kolkata, Eastern India

Purpose: The purpose of this study is to study the pattern of uveitis at a tertiary care hospital in Eastern India. Materials and Methods: This is a prospective study of new cases of uveitis attending our tertiary care hospital in Kolkata, Eastern India, from July 1, 2016, to June 30, 2019. Data regarding patient demographic profile, clinical features, anatomical locations, and etiological diagnosis were evaluated. Results: Among 331 patients, 142 (42.9%) were male and 189 (57.1%) were female (P < 0.05). The mean age at uveitis onset was 32.4 ± 21.13 years (range: 5–61 years). Uveitis was mostly unilateral (77.64%) and nongranulomatous (85.2%). A specific etiology was identified in 187 patients (56.5%). Anterior uveitis was the most common form (183 patients; 55.29%), followed by posterior uveitis (79 patients; 23.87%), panuveitis (51 patients; 15.4%), and intermediate uveitis (18 patients; 5.44%). The most common cause of anterior uveitis was idiopathic (92 cases; 50.27%), followed by seronegative spondyloarthropathy (25 cases; 13.66%). In intermediate uveitis, a specific diagnosis was obtained in eight (44.45%) cases. Presumed tuberculosis, sarcoidosis, and seronegative spondyloarthropathy were among the specific etiological causes. In posterior uveitis, toxoplasmosis was the leading etiological cause (18 cases; 22.78%), followed by presumed tuberculosis and Behçet's disease. In panuveitis cases, a specific diagnosis was established in 33 cases (64.71%). The most common etiology was Behçet's disease (11 cases; 21.57%), followed by Vogt–Koyanagi–Harada disease and presumed tuberculosis. Conclusion: Anterior uveitis was the most common form of uveitis. A specific etiology was found in 56.5% of cases. Behçet's disease, seronegative spondyloarthropathy, presumed tuberculosis, and toxoplasmosis were the leading causes of uveitis.

A 10-Year Saudi Experience of Using Adalimumab in Treating Juvenile Idiopathic Arthritis

Background: Traditionally, management of Juvenile Idiopathic Arthritis (JIA) involves use of non-steroidal anti-inflammatory drugs (NSAIDS) or disease-modifying anti-rheumatic drugs (DMARDs), such as methotrexate (MTX) or sulfasalazine; or steroids. However, in several cases, a low therapeutic response or important side effects is encountered. This study reports our experience in using adalimumab in JIA patients by assessing the efficacy and safety of this treatment in this category of patients. Methods: A retrospective study was conducted among 38 patients with JIA at the Pediatric Department, King Abdulaziz Univesrity Hospital, Jeddah, Saudi Arabia, in the period January 2005-March 2016. Patients’ records were reviewed and relevant demographic and clinical data were collected. Data were analyzed using SPSS version 21 and represented using tables. Results: The 38 patients were distributed as 11 (28.9%) males and 27 (71.1%) females; mean ± SD age was 11.91 ± 4.54 (range = 3 - 19) years. Mean ± SD (range) disease duration was 3.26 ± 2.52 (0 - 12) years and most frequent diagnoses included polyarticular rheumatoid factor (RF) negative form 12 (31.6%), followed by systemic and oligoarticular JIA with 9 (23.7%) cases each. Before adalimumab, fever was present in 13 (34.2%) cases, followed by rash in 8 (21.0%) cases; while 21 (55.3%) were asymptomatic. Thirty-one (81.6%) were in failure of MTX, 19 (50%) of steroids, 7 (18.4%) of NSAIDS and 3 (7.9%) had had intraarticular injections. Biologically, ANA, RF and anti-CCP were positive in 22 (57.9%), 8 (21.1%) and 4 (10.5%) of the cases, respectively. Uveitis was present in 11 (28.9%) of the patients. Analysis of adalimumab efficacy showed 10 (52.6%) cases of complete remission, 9 (23.7%) of partial remission and 9 (23.7%) other where treatment was discontinued. Major adverse effects included local pain (4 [10.5%]), new onset uveitis (1 [2.6%]) and rash (1 [2.6%]), responsible of 1case of treatment discontinuation. Predictors for complete remission on adalimumab were oligoarticular form (β = 3.450, p = 0.009) and negative RF (β = 2.381, p = 0.036); while predictors for nonresponse, whether complete or partial, were polyarticular form (β = ?3.784, p = 0.005) and positive anti-CCP (β = ?3.178, p = 0.021). Conclusion: Adalimumab is an efficient and relatively safe alternative in the treatment of JIA with relatively high remission rates and lower rates of adverse effects. Further multicentre experiences are warranted to prove its efficacy and safety in the Saudi patients.

Features of the course of anterior uveitis associated with HLA-B27 antigen

To perform comparative analysis of the frequency of various complications of anterior uveitis associated with HLA-B27 antigen in patients with and without spondyloarthritis. Retrospective analysis included 189 patients with anterior uveitis (AU) associated with histocompatibility antigen (HLA-B27). The Follow-up period lasted 10 years. 189 patients with AU associated with antigen HLA-B27 were divided into two groups. The first group included 108 patients with various diseases of the spondyloarthritis (SpA) group; the second study group consisted of 81 patient with no signs of SpA. Number of patients with complications was 1.5 times higher in the first group. Complicated cataract, glaucoma, synechiae, myodesopsia occurred significantly more frequently in patients of the first group compared to AU patients of the second group, where idiopathic AU was more prevalent. Cystoid macular edema, corneal degeneration, optic nerve atrophy were observed more often in patients with SpA, but differences between the groups were statistically insignificant. Combination of complications also occurred significantly more often in SpA patients. Comparison of the frequency of AU attacks showed that the amount of uveitis attacks per 100 patient-years was higher in patients with SpA. Mean number of AU attacks per year was also higher in the first study group, but differences between the groups were statistically insignificant. Retrospective analysis of 189 patients with AU associated with HLA-B27 antigen revealed significantly higher frequency of complications, together with more frequent acute episodes in patients with SpA in comparison with patients without it confirming the notion that a systemic inflammatory disease can influence the severity of the course of AU.

Lymphopaenia as a predictor of sarcoidosis in patients with a first episode of uveitis

Background/aimsThe diagnostic properties of conventional diagnostic tests (ACE and chest radiography) for sarcoidosis-associated uveitis are not ideal. The diagnostic value of lymphopaenia for sarcoidosis-associated uveitis is investigated.MethodsA retrospective study of...

Relevance of erythrocyte sedimentation rate and C-reactive protein in patients with active uveitis

PurposeTo relate erythrocyte sedimentation rates (ESR) and C-reactive protein (CRP) values to different uveitis entisties.MethodsA retrospective study of patients with a first episode of active uveitis visiting the Erasmus University Medical Center, uveitis clinic, Rotterdam, the Netherlands, was performed. Levels of ESR and CRP were determined within 2 weeks and 1 week after onset of uveitis, respectively. Uveitis had to be of unknown origin at that moment. The specific etiologic groups were related to ESR and CRP values.ResultsThe majority of patients with uveitis had ESR and/or CRP values within the normal limits and no association of ESR and/or CRP with the specific cause of uveitis was observed. However, elevation of ESR ≥ 60 mm/h and/or CRP ≥ 60 mg/L was mostly seen in patients with systemic immune-mediated diseases (8/59, 14% of all with immune-mediated diseases) or systemic infectious causes (7/38, 18% of all infectious uveitis). Patients with ocular toxoplasmosis typically exhibited normal ESR and CRP (9/11, 82%) while patients with endogenous endophthalmitis had elevated ESR and/or CRP in 6/7, 86%. Sarcoidosis-associated uveitis showed predominantly elevated ESR (13/24, 54%; range 20–59 mm/h in 11/13, 85%). Human immunodeficiency virus–positive patients had more often elevated ESR values when compared to the remainder of patients (9/11, 82% vs. 64/163, 39%, 18%, P = 0.009). The cause of uveitis was established in 19/20 (95%) of patients with ESR ≥ 60 mm/h and/or CRP ≥ 60 mg/L.ConclusionsThe majority of patients with first attack of uveitis had ESR and CRP within the normal limits. Elevated levels of ESR and CRP reflected systemic involvement and high levels of both values were associated with established uveitis cause.

Antituberculous Treatment Itself Might Prevent Visual Impairment in Presumed Tuberculosis-Related Uveitis

ABSTRACT Purpose: To study the risk factors for visual loss in presumed tuberculosis-related uveitis (TRU). Methods: Retrospective observational cohort study of patients with TRU, either treated or not for tuberculosis, from January 2005 to January 2017. Clinical and demographic variables were recorded. Main outcome measure was a loss of visual acuity (VA) of ≥2 Snellen lines. A Generalized Estimation Equation was used to control between-eyes bias. A backward stepwise logistic regression multivariate analysis was conducted to elucidate independent risk factors. Results: One hundred and thirty-eight eyes from 82 patients were included. There were 45 males, median age at onset of uveitis was 40 years (Interquartile range, IQR 24). The median follow-up was 36 months (IQR 49.75) and 51 patients completed antituberculous treatment (ATT) for a mean of 9.37 months. In the multivariate model, ATT was the only independent protective factor for loss of VA (OR 0.13, 95% CI 0.04–0.37, p < 0.001). Conclusion: ATT itself may prevent visual loss in TRU.

Ocular Involvement, Prognosis, and Complications in Behçet's Disease

Ocular Behçet syndrome, which may develop both in children and adults, has high ocular morbidity. Ocular involvement develops in about half of Behçet patients and various symptoms and signs are present as a result of unilateral or bilateral attacks of anterior, intermediate, or posterior uveitis. The syndromic process of the disease is characterized by un-predictable and not self-limiting attacks from one eye to the other. The severity of the disease also changes from patient to patient. Although ocular involvement generally occurs after or mucocutaneous involvement, it may be the first presentation in some cases and the prognosis is bad if the follow up is not sufficient. The prognosis is good in cases of anterior uveitis whereas posterior and panuveitis have a bad prognosis as a result of complications. Hopefully, recent years have demonstrated good results on the visual prognosis with the use of biologic agents.

Intraocular Surgery in Behcet's Disease

Behçet’s disease (BD) is a multisystemic vasculitis characterized by multiorgan involvement presenting with recurrent oral and/or genital ulcerations, skin lesions, and uveitis. Ocular involvement often occurs as remitting panuveitis and retinal vasculitis and the visual prognosis is poor if not treated properly. Relapsing uveitis attacks and chronic steroid administration during the treatment period may increase the risk of cataract and glaucoma formation. Also, recurrent uveitis may lead to severe visual compromise due to several posterior segment complications such as vitreous opacification, vitreoretinal interface changes, retinal neovascularization, cystoid macular edema, and optic atrophy. Systemic drugs including steroids, immunosuppressive, and biologic agents usually decrease the severity and frequency of the uveitis. Cataract, glaucoma, and vitreoretinal surgeries in eyes with uveitis may show some difference from the general practice. In this manuscript, approaches in anterior and posterior segment ocular surgeries in BD patients are reviewed.

Use of Oral Steroids and Immunosuppressant / Immunomodulators in the Treatment of Behcet's Disease-Related Uveitis

Behçet’s disease is a multisystemic inflammatory disease of unknown etiology. Unpredictable severe inflammatory ocular exacerbations are usual during the course of the disease and if these acute attacks did not treat in a fast and effective manner, permanent ocular complications would be inevitable. Immune suppressive drugs combined with high-dose systemic corticosteroids are used in resistant uveitis attacks with severe posterior segment involvement, while topical therapy is sufficient only in cases with anterior segment involvement. But unfortunately, refractory uveitis exacerbations could be seen despite the conventional immunosuppressive treatment.

Interferons in the Treatment of Behçet Uveitis

Behçet disease is a multisystem vasculitis with unknown etiology. Ocular involvement, especially posterior segment involvement is the most devastating manifestation of the disease and is an absolute indication for immunosuppressive treatment. However, immunosuppression with conventional agents may be inadequate to prevent destructive uveitis attacks and consequently visual loss. Interferons that constitute the next step of the treatment are the cytokines, which have antiviral, antiproliferative, and immunomodulatory features. They are quite effective in the treatment of Behçet uveitis. They prevent recurrent attacks and improve visual prognosis. They are used successfully in the treatment of macular edema and retinal neovascularizations. Furthermore, they provide long-term remission after the secession of interferon treatment. The aim of this review is to summarize the mechanism of action and the effectiveness and safety of interferons in the treatment of Behçet uveitis.

Sarcoidosis-related Uveitis: Clinical Presentation, Disease Course, and Rates of Systemic Disease Progression After Uveitis Diagnosis

To document the clinical presentation, treatment, and visual outcome of sarcoid uveitis and to determine the timing and potential risk factors of sarcoidosis progression to symptomatic systemic disease from the time of sarcoid uveitis diagnosis. Retrospective, interventional case series. Subjects: Patients with dual diagnoses of uveitis and presumed/biopsy-proven sarcoidosis. Retrospective review of 143 patient records from the Royal Victorian Eye and Ear Hospital and Eye Surgery Associates in Melbourne, Australia, between October 1990 and April 2014 coded with the dual diagnoses of uveitis and sarcoidosis. Only patients with uveitis and presumed or biopsy-proven sarcoidosis (N= 113) were included. Ascertainment of rate and time (months) to the development of symptomatic systemic sarcoidosis from uveitis onset; comparison of the patient demographics, characteristics of uveitis, treatment, and visual outcome between those who developed systemic sarcoidosis and those who remained systemically asymptomatic. Uveitis was the initial presenting complaint of sarcoidosis in 78.8% (n= 89). Twenty-three patients had concurrent undiagnosed systemic disease at presentation and 29 subsequently developed symptomatic sarcoidosis in an organ uninvolved at uveitis onset. The median time to the development of symptomatic systemic sarcoidosis was 12months. No statistically significant association was ascertained between any particular uveitis characteristic and extraocular sarcoidosis progression. Uveitis was the initial presentation of sarcoidosis in the vast majority of our subjects. Concurrent undiagnosed systemic sarcoidosis was common at the time of uveitis onset. A high index of suspicion for subsequent systemic progression should also be maintained, especially within the first 5 years of the uveitis diagnosis.

Risk Factors and Biomarkers for the Occurrence of Uveitis in Juvenile Idiopathic Arthritis: Data From the Inception Cohort of Newly Diagnosed Patients With Juvenile Idiopathic Arthritis Study.

ObjectiveTo analyze the prognostic value of demographic, clinical, and therapeutic factors and laboratory biomarkers and to assess their role in predicting uveitis occurrence in patients with juvenile idiopathic arthritis (JIA).MethodsPatients with JIA were enrolled within the first year after JIA diagnosis. Demographic and clinical parameters were documented. Serum samples were collected at study enrollment, at 3‐month follow‐up visits within the first year, and then every 6 months. A multivariable Cox regression analysis was performed to evaluate the impact of demographic, clinical, laboratory, and therapeutic parameters on uveitis onset.ResultsWe included 954 JIA patients (67.2% female, 54.2% antinuclear antibody [ANA] positive, mean ± SD age at onset 7.1 ± 4.6 years). Uveitis occurred in 133 patients (observation period 44.5 months). Young age at JIA onset and ANA positivity were significantly associated with the onset of uveitis (both P < 0.001). Treatment of arthritis with methotrexate alone (hazard ratio [HR] 0.18 [95% confidence interval (95% CI) 0.12–0.29], P < 0.001) or combined with etanercept (HR 0.10 [95% CI 0.04–0.23], P < 0.001) or adalimumab (HR 0.09 [95% CI 0.01–0.61], P = 0.014) reduced the risk of uveitis onset and the occurrence of uveitis‐related complications. Predictors of uveitis onset included elevated erythrocyte sedimentation rate at baseline (HR 2.36 [95% CI 1.38–4.02], P = 0.002) and continuing moderate or high disease activity during follow‐up as measured by the 10‐joint clinical Juvenile Arthritis Disease Activity Score (HR 4.30 [95% CI 2.51–7.37], P < 0.001). Additionally, S100A12 levels ≥250 ng/ml at baseline were significantly associated with the risk of uveitis (HR 2.10 [95% CI 1.15–3.85], P = 0.016).ConclusionApart from demographic risk factors and treatment modalities, JIA disease activity scores and laboratory biomarkers could be used to better define the group of JIA patients at high risk of uveitis onset.

Corneal Endothelial Changes in Behçet’s Patients with Inactive Ocular Involvement

ABSTRACTPurpose: The purpose of this article is to evaluate alterations in the corneal endothelial layer in Behçet’s disease (BD) with inactive ocular involvement using specular microscopy.Materials and Methods: Thirty-three eyes of 33 BD patients who had at least one anterior segment involvement and no active inflammation in the last 3 months were included in the study (group 1). Twenty-seven of the 33 BD patients had an anterior uveitis attack and six of them had a panuveitis (both anterior and posterior involvement) attack. Thirty-three eyes of 33 age- and sex-matched healthy subjects were enrolled in the control group (group 2). Corneal endothelial cell density (CD), coefficient of variation (CV), hexagonal cell ratio (HEX), and central corneal thickness (CCT) were measured using specular microscopy (Konan Medical, Nishinomiya, Japan), and the results were compared between groups.Results: The mean CD was 2739 ± 164.18 cells/mm2 in group 1 and 2922 ± 107.60 cells/mm2 in group 2 (p = 0.001). The mean CV was 32.9 ± 4.76 in group 1 and 28.5 ± 3.06 in group 2 (p = 0.001). The mean HEX was 44.7 ± 6.51 in group 1 and 49.7 ± 6.10 in group 2 (p = 0.019). The mean CCT was 545.75 ± 40.89 μ in group 1 and 545.66 ± 30.09 μ in group 2 (p > 0.05).Conclusions: Ocular attacks in our BD patients may have caused permanent changes in the corneal endothelial layer. However, these changes did not lead to corneal decompensation, but further studies are necessary to confirm these results.