Behçet's disease uveitis

M Joubert; A-C Desbois; F Domont; A Ghembaza; A Lejoncour; A Mirouse; G Maalouf; M Leclercq; S Touhami; P Cacoub; B Bodaghi; D Saadoun

doi:10.1016/j.revmed.2023.06.004

Behçet's disease uveitis

Rev Med Interne. 2023 Oct;44(10):546-554. doi: 10.1016/j.revmed.2023.06.004. Epub 2023 Jul 4.

Authors

M Joubert¹, A-C Desbois¹, F Domont¹, A Ghembaza¹, A Lejoncour¹, A Mirouse¹, G Maalouf¹, M Leclercq², S Touhami³, P Cacoub¹, B Bodaghi³, D Saadoun⁴

Affiliations

¹ Department of Internal Medicine and Clinical Immunology, centre de référence des maladies auto-immunes systémiques rares, centre de référence des maladies auto-inflammatoires et de l'amylose inflammatoire, Sorbonne universités, Pitié-Salpêtrière University Hospital, AP-HP, Inserm, UMR_S 959, 83, boulevard de l'Hôpital, 75013 Paris, France.
² Internal Medicine Department, CHU de Rouen, 76000 Rouen, France.
³ Department of Ophtalmology, Sorbonne universités, Pitié-Salpêtrière University Hospital, Paris, France.
⁴ Department of Internal Medicine and Clinical Immunology, centre de référence des maladies auto-immunes systémiques rares, centre de référence des maladies auto-inflammatoires et de l'amylose inflammatoire, Sorbonne universités, Pitié-Salpêtrière University Hospital, AP-HP, Inserm, UMR_S 959, 83, boulevard de l'Hôpital, 75013 Paris, France. Electronic address: david.saadoun@aphp.fr.

PMID: 37414674
DOI: 10.1016/j.revmed.2023.06.004

Abstract

Uveitis in Behçet's disease (BD) is frequent (40% of cases) and is a major cause of morbidity. The age of onset of uveitis is between 20 and 30 years. Ocular involvement includes anterior, posterior or panuveitis. It is non-granulomatous. Uveitis may be the first sign of the disease in 20% of cases or it may appear 2 or 3 years after the first symptoms. Panuveitis is the most common presentation and is more commonly found in men. Bilateralisation usually occurs on average 2 years after the first symptoms. The estimated risk of blindness at 5 years is 10-15%. BD uveitis has several ophthalmological features that distinguish it from other uveitis. The main goals in the management of patients are the rapid resolution of intraocular inflammation, prevention of recurrent attacks, achievement of complete remission, and preservation of vision. Biologic therapies have changed the management of intraocular inflammation. The aim of this review is to provide an update previous article by our team on pathogenesis, diagnostic approaches, identification of factors associated with relapse and the therapeutic strategy of BD uveitis.

Keywords: Agents anti-TNFα; Anti-TNFα agents; Behçet's disease; Biotherapies; Biothérapies; Maladie de Behçet; Uveitis; Uvéite; Vascularite; Vasculitis.

Publication types

Review