Pattern of uveitis in Behçet's disease patients from a highly specialized university hospital-based tertiary care eye unit

Aim of the work: To determine the frequency and pattern of ocular manifestations including uveitis associated with Behcet's disease (BD) in patients referred to a hospital-based tertiary care eye unit. Patients and methods: This study included BD patients referred to the Uveitis Clinic, Cairo University Hospitals. Patterns of systemic and ocular disease were documented. Treatment and complications occurring during followup were added. Results: The study included 113 patients (208 eyes). 86 % were males and 14 % females. Their mean age was 32.1 +/- 9.5 years. Time lapse from diagnosis to referral was 3.8 +/- 4.9 years. 15.9 % had unilateral eye involvement and 84.1 % bilateral. Most common presentation was panuveitis in 64.4 % of eyes, whereas 22.6 % presented with isolated posterior uveitis and 12 % with anterior uveitis. Vasculitis was a common finding at presentation in 27.4 %. During the course of ocular disease the most frequent complication was cataract in 27.4 % and 33 % of patients did not develop complications. At presentation, 47.6 % of eyes were worsening despite treatment, 28.8 % were stationary, 16.3 % were controlled and 7.2 % were improving. The mean best corrected visual acuity dropped from 0.48 +/- 2.36 to 0.29 +/- 0.32 between presentation and last follow up. Visual acuity was significantly reduced in those with panuveitis and optic neuritis (p < 0.001). End-stage eye disease was present in 7.2 % at presentation. Conclusion: Ocular Behcet's is a frequent finding, especially panuveitis. Retinal vasculitis is not uncommon. Delayed referral to tertiary care eye unit remains a loop hole in the health care system. Cataract is a common complication during the course of the disease.