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Behcet is a rare –immune mediated occlusive vasculitis. It affects most organ of the body. Uveitis being the most important of the triple system complex. Eye disease in 20 % leads to blindness even after treatment .It involves both anterior and posterior uvea .When anterior chamber is involved , it is painful with hypopyon .During posterior chamber , it is painless and optic nerve atrophy occurs .Recurrent bouts of inflammation lead to structural damage leading to complication like opacity of cornea and macular degeneration .Uveitis is seldom the initial manifestation of systems disease (1).When uveitis is chronic it is bilateral involving anterior and posterior segment.
Acute uveitis responds to corticosteroids eye drops. Other immunosuppressive agents are Cyclosporin, azathioprine, chlorambucil. Alpha interferon has also been used in uveitis in Behcet .Anti-TNF monoclonal antibody like infliximab causes rapid control of severe and resistant uveitis.
As Professor Moots indicates, treatment for Behcet's disease has been
problematic. Thalidomide has been used for resistant cases, but I and
others have had some extremely good results from using methotrexate. As a
cheap first drug there are no financial barriers, as there are with
biologic agents.
It is also worth noting that many patients with Behcet's improve
spontaneously as they grow older, which may be of some comfort to the
patient who is in big trouble now.
Re: Behçet’s syndrome
Behcet is a rare –immune mediated occlusive vasculitis. It affects most organ of the body. Uveitis being the most important of the triple system complex. Eye disease in 20 % leads to blindness even after treatment .It involves both anterior and posterior uvea .When anterior chamber is involved , it is painful with hypopyon .During posterior chamber , it is painless and optic nerve atrophy occurs .Recurrent bouts of inflammation lead to structural damage leading to complication like opacity of cornea and macular degeneration .Uveitis is seldom the initial manifestation of systems disease (1).When uveitis is chronic it is bilateral involving anterior and posterior segment.
Acute uveitis responds to corticosteroids eye drops. Other immunosuppressive agents are Cyclosporin, azathioprine, chlorambucil. Alpha interferon has also been used in uveitis in Behcet .Anti-TNF monoclonal antibody like infliximab causes rapid control of severe and resistant uveitis.
Reference:
1.Colvard DM, Robertson DM, O’Duffy JD.The ocular manifestation of Behcet’s disease Arch Opthalmol 1977 Oct; 95(10):1813 -17.
Competing interests: No competing interests