FEB 22, 2019
This paper details the clinical characteristics of 25 patients with optic neuropathy from Behçet disease.
The analysis included 25 patients (13 male, 12 female) with a mean age of 36 (range 16–55) who were seen in 5 Turkish university hospitals.
Half of the cohort had an optic neuropathy prior to the diagnosis of Behçet disease, and the remaining patients had a preexisting Behçet diagnosis and subsequently developed optic neuropathy.
Seventeen of 25 patients (68%) had unilateral optic neuropathy. Seven patients had recurrent optic neuropathy; more than half had disc edema or uveitis. Five of the individuals had a multiple sclerosis-like presentation, 3 had parenchymal brainstem involvement. One patient exhibited longitudinally extensive transverse myelitis but no other patient had central nervous system involvement.
Most patients were treated with corticosteroids, with some getting a combination of corticosteroids and other immunosuppressive medication such as azathioprine. Visual prognosis was good in most patients with optic neuropathy.
The main limitation of the study was its retrospective nature and thus inconsistent testing and follow-up. In addition, the authors conceded that the diagnosis of optic neuropathy was “challenging” because uveitis can cause secondary disc edema and visual changes. Lastly, findings from orbital MRI were not provided—therefore it is unclear how many cases were a result of retrobulbar optic neuritis.
Behçet disease can cause optic neuropathy, which can occur early in the disease process or as a late manifestation. Therefore, Behçet disease should be on the differential diagnosis of patients presenting with optic neuropathy, especially if uveitis is present or the patient has oral ulcers.