Demyelination of retinal myelinated nerve fibers in Behcet's disease.
A 39 year-old Behcet's patient had demyelination of retinal myelinated nerve fibers after recurrent papillitis and vitritis. Oral Prednisolone, cyclosporine, and later periocular corticosteroids and oral colchicine were used but demyelination continued over a 5 year-period. A pseudobulbar palsy with urinary incontinence and pyramidal tract signs developed and azathioprine and corticosteroids were used. Demyelination of retinal nerve fibers stopped and while treatment was underway, the central nervous system (CNS) signs were stable. While the ocular pathology of Behcet's can mirror the CNS signs, indeed optic nerve ischemic demyelination may signal the potential for CNS involvement; azathioprine with prednisone may be more effective in the long-term for optic nerve and CNS involvement than cyclosporine with prednisone.
Chavis
P S
PS
King Khaled Eye Specialist Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Tabbara
K F
KF
D000328:Adult; D001528:Behcet Syndrome / Q000150:complications* / Q000188:drug therapy; D003078:Colchicine / Q000008:administration & dosage / Q000627:therapeutic use; D003711:Demyelinating Diseases / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D005500:Follow-Up Studies; D005654:Fundus Oculi; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006074:Gout Suppressants / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007267:Injections; D008297:Male; D009413:Nerve Fibers, Myelinated; D012164:Retinal Diseases / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology
D005938:Glucocorticoids; D006074:Gout Suppressants; D003078:Colchicine