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Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology 11/2005

01.11.2005 | Clinical Investigation

Risk and prognostic factors of poor visual outcome in Behcet's disease with ocular involvement

verfasst von: Masaru Takeuchi, Hideyuki Hokama, Rintaroh Tsukahara, Takeshi Kezuka, Hiroshi Goto, Jun-ichi Sakai, Masahiko Usui

Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology | Ausgabe 11/2005

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Abstract

Purpose

The purpose of the study was to determine factors correlated with the progression of irreversible visual disturbance in Behcet's disease (BD) with ocular involvement.

Methods

Forty-seven BD patients with ocular inflammation, who presented with the first ocular episode, and who had been followed continuously for 5–10 years in our hospital, were studied. Charts were reviewed for gender, onset age of uveitis, complete or incomplete type BD, HLA-B51 status, final visual acuity at the last remission period, mean number of ocular attacks per year, and clinical findings of iridocyclitis with profuse hypopyon, strong vitreous opacity blocking the observation of retinal vessels, diffuse retinal vasculitis, and exudates with hemorrhage within the retinal vascular arcade.

Results

Patients with a visual acuity of ≤20/200 and those with >20/200 differed significantly in the mean number of ocular attacks per year and clinical findings of strong vitreous opacity and exudates within the retinal vascular arcade, but not with regard to the other factors. In addition, the frequency of ocular attacks showed a significant negative correlation with the outcome of visual acuity. Logistic regression analysis indicated a significant association of an average of more than three ocular attacks per year, strong vitreous opacity, and exudates within the retinal vascular arcade with poor visual outcome.

Conclusions

This study indicates that more than three ocular attacks per year, strong vitreous opacity, and exudates within the retinal vascular arcade are the risk and prognostic factors for a poor outcome of visual acuity in BD patients.
Literatur
1.
Zurück zum Zitat Barra C, Belfort Junior R, Abreu MT, Kim MK, Martins MC, Petrilli AM (1991) Behcet's disease in Brazil—a review of 49 cases with emphasis on ophthalmic manifestations. Jpn J Ophthalmol 35:339–346PubMed Barra C, Belfort Junior R, Abreu MT, Kim MK, Martins MC, Petrilli AM (1991) Behcet's disease in Brazil—a review of 49 cases with emphasis on ophthalmic manifestations. Jpn J Ophthalmol 35:339–346PubMed
2.
Zurück zum Zitat Benezra D, Cohen E (1986) Treatment and visual prognosis in Behcet's disease. Br J Ophthalmol 70:589–592PubMedCrossRef Benezra D, Cohen E (1986) Treatment and visual prognosis in Behcet's disease. Br J Ophthalmol 70:589–592PubMedCrossRef
3.
Zurück zum Zitat Chajek T, Fainaru M (1975) Behcet's disease. Report of 41 cases and a review of the literature. Medicine (Baltimore) 54:179–196CrossRef Chajek T, Fainaru M (1975) Behcet's disease. Report of 41 cases and a review of the literature. Medicine (Baltimore) 54:179–196CrossRef
4.
Zurück zum Zitat Chung YM, Liu JH, Tsi ST (1986) Behcet's disease in Taiwan—a review of 53 cases. Jpn J Ophthalmol 30:318–323PubMed Chung YM, Liu JH, Tsi ST (1986) Behcet's disease in Taiwan—a review of 53 cases. Jpn J Ophthalmol 30:318–323PubMed
5.
Zurück zum Zitat De Smet MD, Bitar G, Mainigi S, Nussenblatt RB (2001) Human S-antigen determinant recognition in uveitis. Investig Ophthalmol Vis Sci 42:3233–3238 De Smet MD, Bitar G, Mainigi S, Nussenblatt RB (2001) Human S-antigen determinant recognition in uveitis. Investig Ophthalmol Vis Sci 42:3233–3238
6.
Zurück zum Zitat Demiroglu H, Barista I, Dundar S (1997) Risk factor assessment and prognosis of eye involvement in Behcet's disease in Turkey. Ophthalmology 104:701–705PubMed Demiroglu H, Barista I, Dundar S (1997) Risk factor assessment and prognosis of eye involvement in Behcet's disease in Turkey. Ophthalmology 104:701–705PubMed
7.
Zurück zum Zitat Er H, Evereklioglu C, Cumurcu T, Turkoz Y, Ozerol E, Sahin K, Doganay S (2002) Serum homocysteine level is increased and correlated with endothelin-1 and nitric oxide in Behcet's disease. Br J Ophthalmol 86:653–657CrossRefPubMed Er H, Evereklioglu C, Cumurcu T, Turkoz Y, Ozerol E, Sahin K, Doganay S (2002) Serum homocysteine level is increased and correlated with endothelin-1 and nitric oxide in Behcet's disease. Br J Ophthalmol 86:653–657CrossRefPubMed
8.
Zurück zum Zitat Ermakova NA, Alekberova ZS, Prokaeva TB (2003) Autoimmunity to S-antigen and retinal vasculitis in patients with Behcet's disease. Adv Exp Med Biol 528:279–281PubMedCrossRef Ermakova NA, Alekberova ZS, Prokaeva TB (2003) Autoimmunity to S-antigen and retinal vasculitis in patients with Behcet's disease. Adv Exp Med Biol 528:279–281PubMedCrossRef
9.
Zurück zum Zitat Evereklioglu C, Er H, Turkoz Y, Cekmen M (2002) Serum levels of TNF-alpha, sIL-2R, IL-6, and IL-8 are increased and associated with elevated lipid peroxidation in patients with Behcet's disease. Mediat Inflamm 11:87–93CrossRef Evereklioglu C, Er H, Turkoz Y, Cekmen M (2002) Serum levels of TNF-alpha, sIL-2R, IL-6, and IL-8 are increased and associated with elevated lipid peroxidation in patients with Behcet's disease. Mediat Inflamm 11:87–93CrossRef
10.
Zurück zum Zitat France R, Buchanan RN, Wilson MW, Sheldon MB Jr (1951) Relapsing iritis with recurrent ulcers of the mouth and genitalia (Behcet's syndrome); review: with report of additional case. Medicine (Baltimore) 30:335–355 France R, Buchanan RN, Wilson MW, Sheldon MB Jr (1951) Relapsing iritis with recurrent ulcers of the mouth and genitalia (Behcet's syndrome); review: with report of additional case. Medicine (Baltimore) 30:335–355
11.
Zurück zum Zitat Hamza M, Elleuch M, Slim A, Hamzaoui K, Ayed K (1990) Antibodies to Herpes simplex virus in patients with Behcet's disease. Clin Rheumatol 9:498–500CrossRefPubMed Hamza M, Elleuch M, Slim A, Hamzaoui K, Ayed K (1990) Antibodies to Herpes simplex virus in patients with Behcet's disease. Clin Rheumatol 9:498–500CrossRefPubMed
12.
Zurück zum Zitat Kazokoglu H, Saatci O, Cuhadaroglu H, Eldem B (1991) Long-term effects of cyclophosphamide and colchicine treatment in Behcet's disease. Ann Ophthalmol 23:148–151PubMed Kazokoglu H, Saatci O, Cuhadaroglu H, Eldem B (1991) Long-term effects of cyclophosphamide and colchicine treatment in Behcet's disease. Ann Ophthalmol 23:148–151PubMed
13.
Zurück zum Zitat Kotter I, Zierhut M, Eckstein AK, Vonthein R, Ness T, Gunaydin I, Grimbacher B, Blaschke S, Meyer-Riemann W, Peter HH, Stubiger N (2003) Human recombinant interferon alfa-2a for the treatment of Behcet's disease with sight threatening posterior or panuveitis. Br J Ophthalmol 87:423–431CrossRefPubMed Kotter I, Zierhut M, Eckstein AK, Vonthein R, Ness T, Gunaydin I, Grimbacher B, Blaschke S, Meyer-Riemann W, Peter HH, Stubiger N (2003) Human recombinant interferon alfa-2a for the treatment of Behcet's disease with sight threatening posterior or panuveitis. Br J Ophthalmol 87:423–431CrossRefPubMed
14.
Zurück zum Zitat Lehner T, Stanford MR, Phipps PA, Sun JB, Xiao BG, Holmgren J, Shinnick T, Hasan A, Mizushima Y (2003) Immunopathogenesis and prevention of uveitis with the Behcet's disease-specific peptide linked to cholera toxin B. Adv Exp Med Biol 528:173–180PubMed Lehner T, Stanford MR, Phipps PA, Sun JB, Xiao BG, Holmgren J, Shinnick T, Hasan A, Mizushima Y (2003) Immunopathogenesis and prevention of uveitis with the Behcet's disease-specific peptide linked to cholera toxin B. Adv Exp Med Biol 528:173–180PubMed
15.
Zurück zum Zitat Martin DK, Nelms DC, Mackler BF, Peavy DL (1979) Lymphoproliferative responses induced by streptococcal antigens in recurrent aphthous stomatitis and Behcet's syndrome. Clin Immunol Immunopathol 13:146–155CrossRefPubMed Martin DK, Nelms DC, Mackler BF, Peavy DL (1979) Lymphoproliferative responses induced by streptococcal antigens in recurrent aphthous stomatitis and Behcet's syndrome. Clin Immunol Immunopathol 13:146–155CrossRefPubMed
16.
Zurück zum Zitat Masuda K, Nakajima A, Urayama A, Nakae K, Kogure M, Inaba G (1989) Double-masked trial of cyclosporin versus colchicine and long-term open study of cyclosporin in Behcet's disease. Lancet I:1093–1096CrossRef Masuda K, Nakajima A, Urayama A, Nakae K, Kogure M, Inaba G (1989) Double-masked trial of cyclosporin versus colchicine and long-term open study of cyclosporin in Behcet's disease. Lancet I:1093–1096CrossRef
17.
Zurück zum Zitat Mishima S, Masuda K, Izawa Y, Mochizuki M, Namba K (1979) The eighth Frederick H. Verhoeff lecture presented by Saiichi Mishima, MD. Behcet's disease in Japan: ophthalmologic aspects. Trans Am Ophthalmol Soc 77:225–279PubMed Mishima S, Masuda K, Izawa Y, Mochizuki M, Namba K (1979) The eighth Frederick H. Verhoeff lecture presented by Saiichi Mishima, MD. Behcet's disease in Japan: ophthalmologic aspects. Trans Am Ophthalmol Soc 77:225–279PubMed
18.
Zurück zum Zitat Mizushima Y, Matsumura N, Mori M, Shimizu T, Fukushima B, Mimura Y, Saito K, Sugiura S (1977) Colchicine in Behcet's disease. Lancet II:1037CrossRef Mizushima Y, Matsumura N, Mori M, Shimizu T, Fukushima B, Mimura Y, Saito K, Sugiura S (1977) Colchicine in Behcet's disease. Lancet II:1037CrossRef
19.
Zurück zum Zitat Mizushima Y (1988) Revised diagnostic criteria for Behcet's disease in 1987. Ryumachi 28:66–70PubMed Mizushima Y (1988) Revised diagnostic criteria for Behcet's disease in 1987. Ryumachi 28:66–70PubMed
20.
Zurück zum Zitat Mor F, Weinberger A, Cohen IR (2002) Identification of alpha-tropomyosin as a target self-antigen in Behcet's syndrome. Eur J Immunol 32:356–365CrossRefPubMed Mor F, Weinberger A, Cohen IR (2002) Identification of alpha-tropomyosin as a target self-antigen in Behcet's syndrome. Eur J Immunol 32:356–365CrossRefPubMed
21.
Zurück zum Zitat Niwa Y, Miyake S, Sakane T, Shingu M, Yokoyama M (1982) Auto-oxidative damage in Behcet's disease—endothelial cell damage following the elevated oxygen radicals generated by stimulated neutrophils. Clin Exp Immunol 49:247–255PubMed Niwa Y, Miyake S, Sakane T, Shingu M, Yokoyama M (1982) Auto-oxidative damage in Behcet's disease—endothelial cell damage following the elevated oxygen radicals generated by stimulated neutrophils. Clin Exp Immunol 49:247–255PubMed
22.
Zurück zum Zitat Nussenblatt RB, Palestine AG, Chan CC, Mochizuki M, Yancey K (1985) Effectiveness of cyclosporin therapy for Behcet's disease. Arthritis Rheum 28:671–679PubMedCrossRef Nussenblatt RB, Palestine AG, Chan CC, Mochizuki M, Yancey K (1985) Effectiveness of cyclosporin therapy for Behcet's disease. Arthritis Rheum 28:671–679PubMedCrossRef
23.
Zurück zum Zitat Pivetti Pezzi P, Gasparri V, De Liso P, Catarinelli G (1985) Prognosis in Behcet's disease. Ann Ophthalmol 17:20–25PubMed Pivetti Pezzi P, Gasparri V, De Liso P, Catarinelli G (1985) Prognosis in Behcet's disease. Ann Ophthalmol 17:20–25PubMed
24.
Zurück zum Zitat Reimold AM (2002) TNF-alpha as therapeutic target: new drugs, more applications. Curr Drug Targets Inflamm Allergy 1:377–392CrossRefPubMed Reimold AM (2002) TNF-alpha as therapeutic target: new drugs, more applications. Curr Drug Targets Inflamm Allergy 1:377–392CrossRefPubMed
25.
Zurück zum Zitat Sakamoto M, Akazawa K, Nishioka Y, Sanui H, Inomata H, Nose Y (1995) Prognostic factors of vision in patients with Behcet disease. Ophthalmology 102:317–321PubMed Sakamoto M, Akazawa K, Nishioka Y, Sanui H, Inomata H, Nose Y (1995) Prognostic factors of vision in patients with Behcet disease. Ophthalmology 102:317–321PubMed
26.
27.
Zurück zum Zitat Sancak B, Onder M, Oztas MO, Bukan N, Gurer MA (2003) Nitric oxide levels in Behcet's disease. J Eur Acad Dermatol Venereol 17:7–9CrossRefPubMed Sancak B, Onder M, Oztas MO, Bukan N, Gurer MA (2003) Nitric oxide levels in Behcet's disease. J Eur Acad Dermatol Venereol 17:7–9CrossRefPubMed
28.
Zurück zum Zitat Sfikakis PP, Theodossiadis PG, Katsiari CG, Kaklamanis P, Markomichelakis NN (2001) Effect of infliximab on sight-threatening panuveitis in Behcet's disease. Lancet 358:295–296CrossRefPubMed Sfikakis PP, Theodossiadis PG, Katsiari CG, Kaklamanis P, Markomichelakis NN (2001) Effect of infliximab on sight-threatening panuveitis in Behcet's disease. Lancet 358:295–296CrossRefPubMed
29.
Zurück zum Zitat Tessler HH, Jennings T (1990) High-dose short-term chlorambucil for intractable sympathetic ophthalmia and Behcet's disease. Br J Ophthalmol 74:353–357PubMedCrossRef Tessler HH, Jennings T (1990) High-dose short-term chlorambucil for intractable sympathetic ophthalmia and Behcet's disease. Br J Ophthalmol 74:353–357PubMedCrossRef
30.
Zurück zum Zitat Triolo G, Vadala M, Accardo-Palumbo A, Ferrante A, Ciccia F, Giardina E, Citarrella P, Lodato G, Licata G (2002) Anti-tumour necrosis factor monoclonal antibody treatment for ocular Behcet's disease. Ann Rheum Dis 61:560–561CrossRefPubMed Triolo G, Vadala M, Accardo-Palumbo A, Ferrante A, Ciccia F, Giardina E, Citarrella P, Lodato G, Licata G (2002) Anti-tumour necrosis factor monoclonal antibody treatment for ocular Behcet's disease. Ann Rheum Dis 61:560–561CrossRefPubMed
31.
Zurück zum Zitat Wechsler B, Bodaghi B, Huong DL, Fardeau C, Amoura Z, Cassoux N, Piette JC, LeHoang P (2000) Efficacy of interferon alfa-2a in severe and refractory uveitis associated with Behcet's disease. Ocul Immunol Inflamm 8:293–301CrossRefPubMed Wechsler B, Bodaghi B, Huong DL, Fardeau C, Amoura Z, Cassoux N, Piette JC, LeHoang P (2000) Efficacy of interferon alfa-2a in severe and refractory uveitis associated with Behcet's disease. Ocul Immunol Inflamm 8:293–301CrossRefPubMed
32.
Zurück zum Zitat Wong RC, Ellis CN, Diaz LA (1984) Behcet's disease. Int J Dermatol 23:25–32PubMed Wong RC, Ellis CN, Diaz LA (1984) Behcet's disease. Int J Dermatol 23:25–32PubMed
33.
Zurück zum Zitat Yoshida A, Kawashima H, Motoyama Y, Shibui H, Kaburaki T, Shimizu K, Ando K, Hijikata K, Izawa Y, Hayashi K, Numaga J, Fujino Y, Masuda K, Araie M (2004) Comparison of patients with Behcet's disease in the 1980s and 1990s. Ophthalmology 111:810–815CrossRefPubMed Yoshida A, Kawashima H, Motoyama Y, Shibui H, Kaburaki T, Shimizu K, Ando K, Hijikata K, Izawa Y, Hayashi K, Numaga J, Fujino Y, Masuda K, Araie M (2004) Comparison of patients with Behcet's disease in the 1980s and 1990s. Ophthalmology 111:810–815CrossRefPubMed
Metadaten
Titel
Risk and prognostic factors of poor visual outcome in Behcet's disease with ocular involvement
verfasst von
Masaru Takeuchi
Hideyuki Hokama
Rintaroh Tsukahara
Takeshi Kezuka
Hiroshi Goto
Jun-ichi Sakai
Masahiko Usui
Publikationsdatum
01.11.2005
Verlag
Springer-Verlag
Erschienen in
Graefe's Archive for Clinical and Experimental Ophthalmology / Ausgabe 11/2005
Print ISSN: 0721-832X
Elektronische ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-005-0005-8

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