Uveitis in Behcet disease-an update

Letter Rheumatology

Correspondence on 'A pilot study of tofacitinib for refractory Behcet's syndrome'

Jun Zou et al.

ANNALS OF THE RHEUMATIC DISEASES (2023)

Article Ophthalmology

Long-term outcomes of infliximab in patients with Behcet's disease-associated uveitis

Satoshi Yamana et al.

Summary: Infliximab treatment is effective in controlling ocular inflammatory attacks and reducing ocular disease activities in patients with Behcet's disease-associated uveitis, while also maintaining their visual acuity.

INTERNATIONAL OPHTHALMOLOGY (2023)

Add to Collection

Article Ophthalmology

Clinical Follow-up of Patients with Behcet Uveitis after Discontinuation of Infliximab Therapy

Helin Ceren Kose et al.

Summary: This study evaluated the clinical course of patients with Behcet uveitis after discontinuation of infliximab therapy. The results showed that the disease remained well-controlled after discontinuation, with no significant progression of inflammation.

OCULAR IMMUNOLOGY AND INFLAMMATION (2022)

Add to Collection

Article Ophthalmology

Effectiveness of Infliximab and Interferon Alpha-2a for the Treatment of Behcet's Uveitis: Customizing Therapy according to the Clinical Features

Luca De Simone et al.

Summary: The study aimed to report the long-term results of biologic treatment for severe and refractory Behcet's uveitis, choosing a different biologic agent based on the uveitis clinical features. The study found that both IFN and IFX were effective and well tolerated in treating refractory BU.

OCULAR IMMUNOLOGY AND INFLAMMATION (2022)

Add to Collection

Article Ophthalmology

Lower Relapses Rate With Inf liximab Versus Adalimumab in Sight-Threatening Uveitis: A Multicenter Study of 330 Patients

Georgina Maalouf et al.

Summary: This retrospective study compared the relapse rate of noninfectious uveitis patients treated with infliximab and adalimumab. The results showed that infliximab was associated with a lower relapse risk in sight-threatening uveitis.

AMERICAN JOURNAL OF OPHTHALMOLOGY (2022)

Add to Collection

Review Rheumatology

A treat-to-target approach is needed for Behcet's syndrome

Gulen Hatemi

Summary: The review aims to discuss the T2T strategy for Behcet's syndrome, with recent studies suggesting better outcomes with early use of biologic agents. Fluorescein angiography and Doppler ultrasonography can be used to assess disease remission.

CURRENT OPINION IN RHEUMATOLOGY (2022)

Add to Collection

Article Rheumatology

Emergence of new manifestations during infliximab treatment in Behcet's syndrome

Nur Beyza Tukek et al.

Summary: By reviewing patient data, we found that about 7% of patients with Behcet's syndrome developed new manifestations during treatment with IFX. Vascular involvement was more common in patients with new manifestations. For the majority of these patients, intensifying IFX treatment or adding other agents proved effective in managing the symptoms.

RHEUMATOLOGY (2022)

Add to Collection

Article Rheumatology

Evaluation of sensitivity and specificity of diagnostic criteria for Behcet's disease in the absence of a gold standard

Zhenyu Zhong et al.

Summary: This study aims to evaluate the performance of diagnostic criteria for Behget's disease (BD) in the absence of a gold standard. The results show that the International Criteria for Behget's Disease (ICBD) criteria demonstrated higher sensitivity and specificity than the International Study Group (ISG) criteria in diagnosing BD in uveitis.

RHEUMATOLOGY (2022)

Add to Collection

Article Multidisciplinary Sciences

Retinal microvasculature features in patients with Behcet's disease: a systematic review and meta-analysis

Kai-Bao Ji et al.

Summary: This meta-analysis found that retinal microvasculature features, including macular whole enface vessel density (VD), foveal VD, parafoveal VD, and foveal avascular zones (FAZs), were significantly different between eyes with Behcet's disease (BD) and controls. The findings suggest that optical coherence tomography angiography (OCTA) can be useful for diagnosing and monitoring BD patients.

SCIENTIFIC REPORTS (2022)

Add to Collection

Letter Ophthalmology

Comment on Classification Criteria for Behcet Disease Uveitis

Ilknur Tugal-Tutkun et al.

AMERICAN JOURNAL OF OPHTHALMOLOGY (2022)

Add to Collection

Letter Ophthalmology

Reply to Comment on: Classification Criteria for Behcet Disease Uveitis

Annabelle a. Okada et al.

AMERICAN JOURNAL OF OPHTHALMOLOGY (2022)

Add to Collection

Article Rheumatology

Juvenile Behcet's disease: a tertiary center experience

Zahide Ekici Tekin et al.

Summary: This study aimed to report the demographic, clinical, and therapeutic outcomes of juvenile Behcet's disease in a tertiary center. Findings showed a high prevalence of genital ulceration and family history, with less ocular involvement observed. The main immunosuppressive agent used was azathioprine, with corticosteroids and cyclophosphamide also used in severe cases.

CLINICAL RHEUMATOLOGY (2022)

Add to Collection

Article Ophthalmology

Incidence of ophthalmic involvement in Behcet's disease in the United Kingdom: a British Ophthalmic Surveillance Unit (BOSU) study

Sahar Parvizi et al.

Summary: This study prospectively investigated the incidence and manifestations of ophthalmic Behcet's disease in the UK, finding an annual incidence rate of 0.04 per 100,000 individuals. Most cases involved young patients with bilateral involvement, and common ocular manifestations included vitritis and anterior uveitis. Treatment mainly consisted of corticosteroids, with a few patients receiving disease-modifying drugs or anti-TNF monoclonal antibody therapy.

EYE (2022)

Add to Collection

Article Rheumatology

Patients characteristics in Behcet's Syndrome and their associations with major organ involvement: a single-centre experience of 2118 cases

M. Torgutalp et al.

Summary: Male gender and positive smoking history have a significant influence on the presence of major organ involvement in patients with Behcet's syndrome, while genital ulcers do not have a protective effect.

SCANDINAVIAN JOURNAL OF RHEUMATOLOGY (2022)

Add to Collection

Review Ophthalmology

Effects of anti-TNF biologic drugs on uveitis severity in Behcet patients: systematic review and Meta-analysis

Somayeh Abolhasani et al.

Summary: This study aimed to investigate the effects of anti-TNF biologic drugs on uveitis severity in patients with Behcet's disease. The findings suggest that these biologic drugs can significantly reduce the dose of prednisolone and improve visual acuity levels.

INTERNATIONAL JOURNAL OF OPHTHALMOLOGY (2022)

Add to Collection

Review Medicine, General & Internal

Retinal and choroidal microvascular alterations in Behcet's disease without ocular manifestations: A systematic review and meta-analysis

Shipei Fan et al.

Summary: This study used optical coherence tomography angiography to examine the microvascular alterations in non-ocular Behcet's disease. The results showed significantly lower parafoveal vessel density and larger foveal avascular zone in non-ocular Behcet's disease. This suggests that retinal microvascular alterations occur before the onset of ocular manifestations.

FRONTIERS IN MEDICINE (2022)

Add to Collection

Review Pharmacology & Pharmacy

Anti-tumour necrosis factor-alpha agent therapy, compared with conventional therapy, reduces the relapse of uveitis in patients with behcet's disease: A systematic review of controlled trials

Xinwei Zhou et al.

Summary: This study systematically reviewed the efficacy and safety of anti-TNF-alpha therapy for Behcet's disease patients. The results showed that anti-TNF-alpha therapy reduces relapse rates in uveitis patients compared to traditional immunosuppressants. However, the evidence for using anti-TNF-alpha therapy across the full spectrum of BD subtypes is limited, highlighting the need for caution.

FRONTIERS IN PHARMACOLOGY (2022)

Add to Collection

Article Rheumatology

Clinical heterogeneity of ocular Behcet's syndrome versus intestinal Behcet's syndrome: a cross-sectional study from Shanghai Behcet's syndrome database

Cheng-Cheng Hou et al.

Summary: Ocular Behcet's syndrome (BS) is more prevalent in male patients and is likely to manifest with erythema nodosum and vascular involvement, while intestinal BS tends to have fever and hematologic disorders with higher inflammation markers.

ARTHRITIS RESEARCH & THERAPY (2022)

Add to Collection

Article Ophthalmology

An Algorithm for the Diagnosis of Behcet Disease Uveitis in Adults

Ilknur Tugal-Tutkun et al.

Summary: This study developed a diagnostic algorithm for Behcet's disease (BD) uveitis based on ocular findings, providing a diagnostic tree for BD uveitis that needs validation in future studies.

OCULAR IMMUNOLOGY AND INFLAMMATION (2021)

Add to Collection

Article Ophthalmology

Long-term efficacy of early infliximab-induced remission for refractory uveoretinitis associated with Behcet's disease

Hiroshi Keino et al.

Summary: Infliximab (IFX) therapy has long-term efficacy for refractory uveoretinitis associated with Behcet's disease (BD), with better outcomes seen in patients with a shorter duration of uveoretinitis prior to treatment, resulting in improved maintenance of good visual acuity.

BRITISH JOURNAL OF OPHTHALMOLOGY (2021)

Add to Collection

Article Ophthalmology

Macular structural changes and factors affecting final visual acuity in patients with Behcet uveitis

F. Nilufer Yalcindag et al.

Summary: In patients with Behcet uveitis, changes in macular structure during active and remission periods were evaluated using SD-OCT. Ellipsoid zone damage and loss of normal foveal contour appearance were identified as important factors affecting final visual acuity.

GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY (2021)

Add to Collection

Article Ophthalmology

Role of Adalimumab Biosimilar in the Treatment of Non-Anterior Uveitis Associated with Behcet's Syndrome

Jurgen Sota et al.

Summary: The study demonstrates the significant efficacy of SB5 in treating Behcet's syndrome-related uveitis, showing its ability to control inflammation relapses, resolve retinal vasculitis, and preserve visual acuity.

OPHTHALMOLOGY AND THERAPY (2021)

Add to Collection

Article Rheumatology

Long-term Follow-up and Optimization of Infliximab in Refractory Uveitis Due to Behcet Disease: National Study of 103 White Patients

Jose Luis Martin-Varillas et al.

Summary: In White patients with refractory uveitis due to BD, treatment with IFX showed long-term efficacy and relative safety. IFX optimization after achieving ocular remission was found to be effective, safe, and cost-effective.

JOURNAL OF RHEUMATOLOGY (2021)

Add to Collection

Article Ophthalmology

Comparison of Sociodemographic Features Between Behcet Uveitis and Other Non-infectious Uveitis

F. Nilufer Yalcindag et al.

Summary: This study found that patients with Behcet disease had lower education level and socioeconomic status compared to patients with other non-infectious uveitis entities.

TURK OFTALMOLOJI DERGISI-TURKISH JOURNAL OF OPHTHALMOLOGY (2021)

Add to Collection

Article Ophthalmology

MONTHLY INTRAVITREAL INFLIXIMAB IN BEHcET'S DISEASE ACTIVE POSTERIOR UVEITIS A Long-Term Safety Study

Mohammad Refaat et al.

Summary: The study on the safety and efficacy of extended monthly intravitreal infliximab injections in patients with active posterior uveitis in Behcet's disease revealed that the treatment was associated with a high complication rate and failure to control inflammation in most eyes, indicating that it should not be considered a substitute to systemic therapy.

RETINA-THE JOURNAL OF RETINAL AND VITREOUS DISEASES (2021)

Add to Collection

Article Ophthalmology

An open-label, prospective, single-arm study of switching from infliximab to cyclosporine for refractory uveitis in patients with Behcet's disease in long-term remission

Yasutsugu Ida et al.

Summary: Although no ocular attacks were observed for at least 1 year after IFX withdrawal, this prospective study indicates that IFX withdrawal should be considered carefully, even for patients in long term remission of ocular and extraocular lesions.

JAPANESE JOURNAL OF OPHTHALMOLOGY (2021)

Add to Collection

Article Multidisciplinary Sciences

Peripapillary optical coherence tomography as an alternative to fluorescein angiography for monitoring Behcet's retinal vasculitis

Mohammad Zarei et al.

Summary: This study investigated the correlation of OCT parameters with fluorescein angiography in evaluating inflammatory activity in Behcet's retinal vasculitis. Results showed that parameters such as CSMT, PRT2.2, PRT3.45, and PNFLT had significant correlation with FA scores, with PRT3.45 and PNFLT showing the strongest correlation with angiographic inflammatory activity. These parameters may serve as non-invasive alternatives to FA for monitoring Behcet's retinal vasculitis.

SCIENTIFIC REPORTS (2021)

Add to Collection

Article Medicine, General & Internal

Clinical profile and evolution of patients with juvenile-onset Behcet's syndrome over a 25-year period: insights from the AIDA network

Jurgen Sota et al.

Summary: In a cohort of pediatric Behcet's syndrome (BS) patients managed in three tertiary referral centers in Italy, the mean age of first symptom-appearance was around 10.92 years with a female predominance. Pediatric patients mainly presented with mucocutaneous signs and had less frequent major organ involvement compared to adult-onset patients.

INTERNAL AND EMERGENCY MEDICINE (2021)

Add to Collection

Article Rheumatology

Clinical phenotypes of Behcet's syndrome in a large cohort of Italian patients: focus on gender differences

P. Leccese et al.

Summary: This study aimed to investigate clinical phenotypes of Italian Behcet's syndrome (BS) patients by gender. Males were more likely to have papulopustolar lesions, posterior uveitis, and deep venous thrombosis, while females were more likely to have erythema nodosum and arthralgia. There were no significant differences in HLA-B51 status between male and female patients. BS tended to be less aggressive in Italian female patients.

SCANDINAVIAN JOURNAL OF RHEUMATOLOGY (2021)

Add to Collection

Article Ophthalmology

Macular Cone Abnormalities in Behcet's Disease Detected by Adaptive Optics Scanning Light Ophthalmoscope

Shin Kadomoto et al.

Summary: This study revealed macular photoreceptor damage in Behcet's disease patients with and without a history of uveitis, as shown by AOSLO imaging. The cone density was significantly reduced in BD patients with uveitis history, and the proportion of hexagonal Voronoi domains was also significantly lower in BD eyes compared to controls.

OPHTHALMIC SURGERY LASERS & IMAGING RETINA (2021)

Add to Collection

Review Rheumatology

Advances in the Treatment of Behcet's Disease

Fatma Alibaz-Oner et al.

Summary: The main agents for inducing remission in Behcet's disease are glucocorticoids, with azathioprine being the first-line conventional immunosuppressant for maintenance. Apremilast is approved for oral ulcers, while TNF alpha inhibitors and Interferon-alpha have shown effectiveness in large case series. Promising results are also seen with IL-1 inhibitors, ustekinumab, secukinumab, and tocilizumab for refractory Behcet's disease.

CURRENT RHEUMATOLOGY REPORTS (2021)

Add to Collection

Article Pharmacology & Pharmacy

The Efficacy of Adalimumab as an Initial Treatment in Patients with Behcet's Retinal Vasculitis

Shizhao Yang et al.

Summary: The study compared the efficacy of ADA with conventional therapy in treating retinal vasculitis in initial treatment of Behcet's Uveitis patients. The results showed significant improvements in patients in the ADA group, with fewer relapses, longer remission periods, better BCVA improvement, inflammation control, and lower glucocorticoid dosages compared to the conventional therapy group.

FRONTIERS IN PHARMACOLOGY (2021)

Add to Collection

Article Pharmacology & Pharmacy

Comparison of the Safety and Efficacy of Interferon Alpha-2a and Cyclosporine-A When Combined With Glucocorticoid in the Treatment of Refractory Behcet's Uveitis: A Randomized Controlled Prospective Study

Yujing Qian et al.

Summary: In the treatment of refractory Behcet's uveitis, IFN-alpha 2a appears to induce a better treatment response, significantly greater improvement in visual acuity, and more stable remission of intraocular inflammation compared to CsA.

FRONTIERS IN PHARMACOLOGY (2021)

Add to Collection

Article Ophthalmology

Post-remission retinal microvascular and choroidal thickness changes in eyes with Behcet's disease posterior uveitis: an OCTA longitudinal study

Amr Mohamed Abdelaziz Wassef et al.

Summary: The study investigated changes in retinal microvascular and choroidal thickness in eyes with active Behcet's disease posterior uveitis. It was found that with remission of the disease, capillary density increased in both layers, with a significant increase in the superficial capillary plexus, while the foveal avascular zone area also increased.

INTERNATIONAL OPHTHALMOLOGY (2021)

Add to Collection

Article Medicine, General & Internal

Vascular Abnormalities in Peripapillary and Macular Regions of Behcet's Uveitis Patients Evaluated by Optical Coherence Tomography Angiography

Chun Yan et al.

Summary: The study revealed that patients with Behcet's uveitis showed significantly reduced vascular density in the peripapillary zone, especially in the inferior subfield of RPCN. There was a significant correlation between the reduction in RPCN vascular density and decreased BCVA in BU patients.

FRONTIERS IN MEDICINE (2021)

Add to Collection

Article Rheumatology

Clinical manifestations of Behcet's syndrome: A single-center cohort of 777 patients

Cemal Gurbuz et al.

Summary: Behcet's syndrome (BS) is a multisystem variable vessel vasculitis characterized by skin-mucosal lesions, which can involve various organ systems. Male patients tend to have more severe involvement, with differences in clinical presentation influenced by gender, age, and skin pathergy test positivity.

EUROPEAN JOURNAL OF RHEUMATOLOGY (2021)

Add to Collection

Article Ophthalmology

Classification Criteria for Behcet Disease Uveitis

Douglas A. Jabs et al.

Summary: Machine learning and formal consensus techniques were used to determine classification criteria for Behcet disease uveitis. The criteria showed high accuracy and included a diagnosis of Behcet disease and compatible uveitis manifestations.

AMERICAN JOURNAL OF OPHTHALMOLOGY (2021)

Add to Collection

Review Immunology

Evaluation of disease activity in uveoretinitis associated with Behcet's disease

Hiroshi Keino

Summary: Behcet's disease is a systemic inflammatory disorder with ocular involvement, more common and severe in men. The BOS24 scoring system is crucial for assessing disease activity in ocular Behcet's disease patients in clinical practice.

IMMUNOLOGICAL MEDICINE (2021)

Add to Collection

Article Ophthalmology

Fluorescein angiographic findings and Behcet's disease ocular attack score 24 (BOS24) as prognostic factors for visual outcome in patients with ocular Behcet's disease

Narumon Keorochana et al.

Summary: The study found that optic disc hyperfluoresence, diffuse posterior pole leakage, and diffuse peripheral leakage were common findings in patients with ocular Behcet's disease. Higher BOS24 scores, arterial narrowing, and severe posterior pole leakage were significantly associated with poor visual outcome. Fluorescein angiography is an important tool for predicting poor visual outcomes in these patients.

INTERNATIONAL JOURNAL OF RETINA AND VITREOUS (2021)

Add to Collection

Article Rheumatology

Diagnosis of Behcet's disease: clinical characteristics, diagnostic criteria, and differential diagnoses

Mina Kiafar et al.

Summary: This study aimed to describe the clinical characteristics of patients at a referral Behcet clinic, confirming that ocular and genital lesions were more prevalent in the BD group, while oral lesions, articular involvement, and gastrointestinal manifestations were similar between groups. Patients with BD were also more likely to have multi-organ involvement. The findings of this study are important for epidemiological research and for referral Behcet clinics dealing with high pretest probability patients.

BMC RHEUMATOLOGY (2021)

Add to Collection

Article Rheumatology

Cluster analysis of phenotypes of patients with Behcet's syndrome: a large cohort study from a referral center in China

Jun Zou et al.

Summary: Behcet's syndrome (BS) is a complex disorder with debated subgroup classification. This study in China confirmed sex differences in BS phenotype and identified gastrointestinal, uveitis, and cardiovascular involvement clusters separately. Further research is needed to replicate and clarify the patterns of phenotype in BS.

ARTHRITIS RESEARCH & THERAPY (2021)

Add to Collection

Article Rheumatology

Changes in the proportion of clinical clusters contribute to the phenotypic evolution of Behcet's disease in Japan

Yutaro Soejima et al.

Summary: This study identified five independent clinical clusters among BD patients in Japan and found that the proportion of each cluster varied over time. The five clusters are mucocutaneous, mucocutaneous with arthritis, neuro, GI, and eye. Recent phenotypical evolutions of BD in Japan were associated with changing proportions of these clinical clusters.

ARTHRITIS RESEARCH & THERAPY (2021)

Add to Collection

Article Medicine, General & Internal