Childhood-onset uveitis in Behcet disease: A descriptive study of 36 cases

PURPOSE: To describe the demographic and clinical features, complications, treatment, and visual results in patients with childhood-onset Behcet uveitis. DESIGN: Observational case series. METHODS: A retrospective study was made of 36 consecutive patients with Behcet disease seen at the Uveitis Service, Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, between January 1975 and January 2002. Inclusion criteria were fulfillment of the classification criteria of the International Study Group for Behcet Disease and onset of uveitis at 16 years of age or younger. The medical records of 36 patients with childhood,onset Behcet uveitis were reviewed. The main outcome measures were sex, age at onset of uveitis, the initial symptom of Behcet disease, clinical ocular features, ocular complications, systemic treatment, complications of treatment, and final visual acuity. RESULTS: Twenty-five patients were male, 11 were female. Mean age at onset of uveitis was 13.6 years. The initial symptom was oral ulcer in 63.8% of the patients. The majority of patients (83.3%) had bilateral involvement. Panuveitis was the most common form (86.2%). Retinal vasculitis and retinitis were the most common ocular findings seen in 83.3% and 68.2% of the involved eyes, respectively. Cataract, maculopathy, and optic atrophy were the most common complications seen in 46.9%, 45.4%, and 39.4% of the involved eyes, respectively. Immunosuppressive therapy was administered to 75% of the patients. Response to treatment was variable. The most common complications of systemic treatment were associated with corticosteroid therapy. Final visual acuity was worse than 0.1 in 22.7 % of the involved eyes. CONCLUSIONS: Childhood,onset Behcet uveitis was more common among males. Bilateral panuveitis with retinal vasculitis and retinitis was the most common form of ocular involvement, similar to the adult patient. The treatment is challenging, as the use oral corticosteroids is associated with significant complications and the response to conventional immunosuppressive therapy is variable. (C) 2003 by Elsevier Inc. All rights reserved.