title: Behçet disease: visual prognosis and factors influencing the development of visual loss.
abstract: OBJECTIVE
  To assess the visual prognosis of patients with ocular Behçet disease and to determine factors predictive of visual loss and severe visual loss.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  One hundred seventy-five eyes of 107 patients diagnosed with ocular Behçet disease were included. The main outcome measures were visual loss (best-corrected visual acuity, worse than 20/40) and severe visual loss (best-corrected visual acuity, 20/200 or worse).
  
  
  RESULTS
  The mean duration of follow-up was 6.5 years. Presenting visual acuity was worse than 20/40 in 50% of eyes and 20/200 or worse in 21% of eyes; approximately one third of this was reversible with treatment. The most common cause of irreversible severe visual loss was ischemic maculopathy. At 10 years, there was a 39% risk of visual loss and a 24% risk of severe visual loss, the latter figure being reduced to 13% if patients with irreversible visual loss at presentation were excluded. After controlling for potentially confounding variables, male sex, unilateral disease, and left eye involvement all were statistically significant risk factors for severe visual loss at 5 and 10 years. Patients who were treated with biologic agents were less likely to have severe visual loss in either eye at both 5 and 10 years.
  
  
  CONCLUSIONS
  Many patients with ocular Behçet disease still have irreversible visual loss at presentation. However, the visual prognosis is otherwise improved, with a 10-year risk of severe visual loss of 13% in this cohort. The use of biologic agents is associated with a lower risk of severe visual loss at 5 and 10 years.
authors.affiliation: Institute of Ophthalmology, University College London, United Kingdom. s.r.taylor@ucl.ac.uk
authors.forename: Simon R J
authors.initials: SR
authors.lastname: Taylor
authors.forename: Jasmin
authors.initials: J
authors.lastname: Singh
authors.forename: Victor
authors.initials: V
authors.lastname: Menezo
authors.forename: Denis
authors.initials: D
authors.lastname: Wakefield
authors.forename: Peter
authors.initials: P
authors.lastname: McCluskey
authors.forename: Sue
authors.initials: S
authors.lastname: Lightman
mesh_terms: D000293:Adolescent; D000328:Adult; D001528:Behcet Syndrome / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D001766:Blindness / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015354:Vision, Low / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D014792:Visual Acuity / Q000502:physiology*; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D011239:Prednisolone