Behçet's disease: comparing 3 decades of treatment response at the National Eye Institute.
BACKGROUND
The goal of the present study was to analyze differences in response to the treatment of ocular Behçet's disease (BD) in the 1960s, 1980s, and 1990s.


METHODS
Medical records of 120 patients with uveitis due to BD followed at the National Eye Institute, National Institutes of Health, from 1962 to 2004, were reviewed.


RESULTS
The patients were categorized into 3 groups according to the time of follow-up: the first group was followed from 1962 until 1972, the second group from 1983 until 1992, and the third group from 1992 through 2004. Snellen visual acuity was converted to logMAR values. The range of values for inflammation was 0.5 (trace), 1 (mild), 2 (moderate), and 3 (severe). There were 45 patients (89 affected eyes) in the 1960s group, 26 patients (52 eyes) in the 1980s group, and 49 patients (94 eyes) in the most recent group. Statistical analysis showed that the mean logMAR score decreased with each decade. Mean visual acuity in the 1990s group was significantly better than in the previous decades (p < 0.001 for the 1960s group and p = 0.019 for the 1980s). The mean inflammation score was significantly higher in the 1960s than in the subsequent decades (p < 0.001 both for the 1980s and for the 1990s).


CONCLUSIONS
BD is a severe, blinding disorder. There was a definitive trend toward improvement in clinical outcome from the 1960s to 1990s. We attribute this trend to the introduction of newer, more potent corticosteroid-sparing agents and targeted therapy.
Kump
Leila I
LI
National Eye Institute, National Institutes of Health, Bethesda, MD, USA.
Moeller
Kristy L
KL
Reed
George F
GF
Kurup
Shree K
SK
Nussenblatt
Robert B
RB
Levy-Clarke
Grace A
GA
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001528:Behcet Syndrome / Q000188:drug therapy* / Q000453:epidemiology; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009316:National Institutes of Health (U.S.); D009885:Ophthalmology; D015864:Panuveitis / Q000188:drug therapy* / Q000453:epidemiology; D012189:Retrospective Studies; D017678:Sex Distribution; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States; D014792:Visual Acuity; D044465:White People
D007166:Immunosuppressive Agents