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Şahin A, Batu Oto B, Uzun Adatepe N, Uçar D. Investigation of optic nerve function in Behçet's patients with optic disc hyperfluorescence in fundus fluorescein angiography. Int Ophthalmol 2024; 44:76. [PMID: 38351422 DOI: 10.1007/s10792-024-02927-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 12/17/2023] [Indexed: 02/16/2024]
Abstract
PURPOSE The aim was to investigate the changes in optic nerve function that may help in the diagnosis of subclinical optic nerve involvement in patients with Behçet's disease (BD) and isolated optic disc (OD) hyperfluorescence in fluorescein angiography (FA). MATERIALS AND METHODS Three groups were formed; BD patients with isolated OD hyperfluorescence in FA, BD patients without ocular involvement (normal FA) and control group. A total of 88 eyes of 45 patients were included. The groups were compared in terms of OCT-RNFL, contrast sensitivity and VEP latency. RESULTS When the OCT-RNFL values were compared, there was a significant difference between the control group and Behçet's patients with normal FA. Contrast sensitivity values differed significantly among the groups, and the lowest mean contrast sensitivity was observed in the group with OD hyperfluorescence (p < 0.05). CONCLUSION As far as we know, this is the first publication that investigates optic nerve function in BD patients with isolated OD hyperfluorescence in FA. Assessment with FA of asymptomatic BD patients with visual complaints and low contrast sensitivity may be helpful at early detection of inflammatory optic neuropathy by close follow-up in patients with OD hyperfluorescence.
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Affiliation(s)
- Atilla Şahin
- Department of Ophthalmology, Bezmialem Vakıf University, Istanbul, Turkey
| | - Bilge Batu Oto
- Department of Ophthalmology, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, 34098, Istanbul, Turkey
| | - Nurten Uzun Adatepe
- Department of Neurology, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Didar Uçar
- Department of Ophthalmology, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, 34098, Istanbul, Turkey.
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Değirmenci MFK, Yalçındağ FN. Are optical coherence tomography and fluorescein angiography comparable for detection of macular edema in Behçet uveitis? Graefes Arch Clin Exp Ophthalmol 2023; 261:3275-3281. [PMID: 37773289 DOI: 10.1007/s00417-023-06249-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 09/17/2023] [Accepted: 09/19/2023] [Indexed: 10/01/2023] Open
Abstract
PURPOSE To investigate the role and agreement of spectral domain optical coherence tomography (SD-OCT) and fluorescein angiography (FA) for macular edema (ME) diagnosis in Behçet uveitis (BU). METHODS Eyes with ME detected by SD-OCT and/or FA were enrolled. Type of ME by SD-OCT and grade of macular leakage (ML) by FA were investigated. Eyes were divided into three groups according to the agreement of tests. Three groups and factors that could affect the compatibility of tests were statistically analyzed. RESULTS Sixty-one eyes of 61 patients were included. Both imaging methods detected ME in 42.6% of eyes (group 1). In 47.5% of eyes, ME was revealed by OCT (group 2). The remaining 9.8% of the eyes had ME, detected only by FA (group 3). Grade 2 ML by FA was more common in group 1 (p = 0.01). The grade of ML by FA was similar in groups 2 and 3. In group 2, most of the eyes showed diffuse ME by OCT (p < 0.001). Epiretinal membrane was detected more frequently in group 3 (p = 0.005). Duration and activity of uveitis were similar between groups. CONCLUSION SD-OCT was able to detect ME in 90% of the eyes with BU. Duration and activity of uveitis were not related to the compatibility of imaging methods.
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Affiliation(s)
| | - F Nilüfer Yalçındağ
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey
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Al Kharousi N, Alnaabi KSK, Almahrouqi O, Mal W. Visual outcomes and factors predictive of visual loss in Behcet's disease in Sultan Qaboos University Hospital, Oman. Oman J Ophthalmol 2022; 15:269-273. [PMID: 36760938 PMCID: PMC9905896 DOI: 10.4103/ojo.ojo_68_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 09/30/2022] [Accepted: 10/01/2022] [Indexed: 02/11/2023] Open
Abstract
PURPOSE This study aimed to evaluate the visual outcomes and associated factors in Omani patients with Behcet's disease (BD). METHODOLOGY This is a descriptive retrospective analytical cohort study. All Omani patients of age 5-65 years with a confirmed clinical diagnosis of BD having ocular manifestation who attended the Rheumatology and Ophthalmology clinics at Sultan Qaboos University Hospital, Oman from January 2018 to October 2020. The demographic data, clinical findings, systemic, and ocular examination of all the recruited patients were retrieved from the electronic patient record. RESULTS The study included 31 male and 16 female participants. The median age is 29.7 ± 10.6 years. Most patients with ocular manifestations presented in the third decade of their life (21-30 years' age). The most common ocular manifestations in our study were uveitis (91.5%) followed by vitritis (40.4%), and retinal vasculitis (36.2%). The most common ocular complications in order of frequency were cataract (27.7%), posterior synechiae (23.4%), and cystoid macular edema (21.2%). In this study, 22.7% of the patients with BD-related ocular manifestations reported severe visual loss. In addition, when adding the patients with severe visual loss secondary to complications such as secondary glaucoma and optic nerve atrophy, the severe visual loss cumulatively reported being 50% for both groups. CONCLUSION The clinical characteristics of ocular manifestations in BD in Oman are similar to data from studies that have been conducted in other countries. However, our study found that the severity of ocular manifestations was more dominant among females. This study finding can be helpful for clinicians to predict ocular manifestations of BD to plan a timely follow-up and subsequently prevent further severe complications or visual loss.
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Affiliation(s)
- Nadiya Al Kharousi
- Department of Ophthalmology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Khalfan Salim Khalfan Alnaabi
- Department of Ophthalmology, College of Medicine and Health Science, Muscat, Oman,Address for correspondence: Dr. Khalfan Salim Khalfan Alnaabi, College of Medicine and Health Science, Sultan Qaboos University, P. O. Box 35 Al-Khod, PC 123, Muscat, Oman. E-mail:
| | - Omar Almahrouqi
- Department of Ophthalmology, College of Medicine and Health Science, Muscat, Oman
| | - Washoo Mal
- Department of Ophthalmology, Sultan Qaboos University Hospital, Muscat, Oman
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Tang F, Zhou Z, Huang K, Deng W, Lin J, Chen R, Li M, Xu F. MicroRNAs in the regulation of Th17/Treg homeostasis and their potential role in uveitis. Front Genet 2022; 13:848985. [PMID: 36186459 PMCID: PMC9515448 DOI: 10.3389/fgene.2022.848985] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 08/24/2022] [Indexed: 11/25/2022] Open
Abstract
Th17 and regulatory T cells (Tregs) play crucial roles in the pathogenesis of autoimmune diseases. Th17/Treg homeostasis is critically involved in maintaining the immune balance. Disturbed Th17/Treg homeostasis contributes to the progression of autoimmune diseases. MicroRNAs (miRNAs) have emerged as a new vital factor in the regulation of disturbed Th17/Treg homeostasis. To better understand the epigenetic mechanisms of miRNAs in regulating Treg/Th17 homeostasis, we included and evaluated 97 articles about autoimmune diseases and found that miRNAs were involved in the regulation of Treg/Th17 homeostasis from several aspects positively or negatively, including Treg differentiation and development, Treg induction, Treg stability, Th17 differentiation, and Treg function. Uveitis is one of the ocular autoimmune diseases, which is also characterized with Th17/Treg imbalance. However, our understanding of the miRNAs in the pathogenesis of uveitis is elusive and not well-studied. In this review, we further summarized miRNAs found to be involved in autoimmune uveitis and their potential role in the regulation of Th17/Treg homeostasis.
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Affiliation(s)
| | | | | | | | | | | | - Min Li
- *Correspondence: Fan Xu, ; Min Li,
| | - Fan Xu
- *Correspondence: Fan Xu, ; Min Li,
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Özgürtaş T, Yücel Ç, Sertoğlu E, Hayran Y, Çolak S, Tekgöz E, Omma A, Durukan AH. Evaluation of the relationship of lymphangiogenesis markers with disease pathogenesis in patients with Behçet's uveitis. Acta Clin Belg 2022; 77:387-395. [PMID: 33629934 DOI: 10.1080/17843286.2021.1890451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The present study aims to evaluate the relationship between Behçet's uveitis and lymphangiogenesis by determining levels of Vascular endothelial growth factor-C (VEGF-C, its receptors sVEGFR-2, sVEGFR-3 and lymphangiogenesis markers podoplanin (PDPN) and lymphatic vessel endothelial hyaluronan receptor 1(LYVE-1), and C-type lectin domain family 1 member B (CLEC2). MATERIALS AND METHODS 55 patients with BD uveitis and 31 healthy control subjects were enrolled in the study. RESULTS sVEGFR-2, sVEGFR-3, VEGF-C/sVEGFR-2 ratio, PDPN and LYVE-1 levels were higher in the patient group. A positive correlation was found between LYVE-1 and hsCRP levels. PDPN had a strong predictive value for progression with a cut-off value of 2 pg/mL, with 69% sensitivity and 68% specificity (p = 0.001). CONCLUSION LYVE-1 and PDPN can be good representatives of the ongoing inflammatory processes in BD uveitis and point out that the disease can be related to lymphangiogenesis.
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Affiliation(s)
- Taner Özgürtaş
- Department of Clinical Biochemistry, Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Çiğdem Yücel
- Department of Clinical Biochemistry, Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Erdim Sertoğlu
- Department of Clinical Biochemistry, Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Yıldız Hayran
- Department of Dermatology, Ankara City Hospital, Ankara, Turkey
| | - Seda Çolak
- Department of Rheumatology, Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Emre Tekgöz
- Department of Rheumatology, Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ahmet Omma
- Department of Rheumatology, Ankara City Hospital, Ankara, Turkey
| | - Ali Hakan Durukan
- Department of Ophthalmology, Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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Chung KB, Choi S, Bang D, Kim DY. Skin manifestation as an explaining factor of heterogeneity in Behçet's disease: A focused analysis in full-blown conditions. J Dermatol 2021; 49:349-358. [PMID: 34862651 DOI: 10.1111/1346-8138.16250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 10/24/2021] [Accepted: 11/11/2021] [Indexed: 11/30/2022]
Abstract
Behçet's disease (BD), a chronic multi-systemic disorder, presents diverse clinical manifestations depending on patient ethnicity and geographic region. Use of varying diagnostic criteria augments clinical heterogeneity. We aimed to characterize heterogenous manifestations in patients with full-blown BD fulfilling the major diagnostic criteria in use. We retrospectively analyzed 338 patients diagnosed with complete BD based on Japanese diagnostic criteria, which fulfill both International Study Group (ISG) criteria and the International Criteria for BD (ICBD). Unbiased clustering analysis was performed to elucidate the heterogeneous spectrum, followed by subgroup analysis of identified clusters. Results of unbiased clustering analysis identify dominant skin lesion type as an important factor that determines clustering among the heterogenous BD patients. Regression analysis reveals that presence of predominantly papulopustular lesions has protective effect for vascular involvement compared to other skin phenotypes. In conclusion, unbiased clustering analysis highlights that dermatologic manifestation can be a factor to understand the heterogeneity of BD and determining the dominant type of skin lesions may help clinicians predict major vascular involvement.
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Affiliation(s)
- Kyung Bae Chung
- Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sooyie Choi
- Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dongsik Bang
- Department of Dermatology, International St. Mary's Hospital, Catholic Kwandong University, Incheon, Republic of Korea
| | - Do-Young Kim
- Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
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Glover K, Mishra D, Singh TRR. Epidemiology of Ocular Manifestations in Autoimmune Disease. Front Immunol 2021; 12:744396. [PMID: 34795665 PMCID: PMC8593335 DOI: 10.3389/fimmu.2021.744396] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 10/14/2021] [Indexed: 01/19/2023] Open
Abstract
The global prevalence of autoimmune diseases is increasing. As a result, ocular complications, ranging from minor symptoms to sight-threatening scenarios, associated with autoimmune diseases have also risen. These ocular manifestations can result from the disease itself or treatments used to combat the primary autoimmune disease. This review provides detailed insights into the epidemiological factors affecting the increasing prevalence of ocular complications associated with several autoimmune disorders.
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Affiliation(s)
| | | | - Thakur Raghu Raj Singh
- School of Pharmacy, Medical Biology Centre, Queen’s University Belfast, Belfast, United Kingdom
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Megha KB, Joseph X, Akhil V, Mohanan PV. Cascade of immune mechanism and consequences of inflammatory disorders. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2021; 91:153712. [PMID: 34511264 PMCID: PMC8373857 DOI: 10.1016/j.phymed.2021.153712] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 08/07/2021] [Accepted: 08/15/2021] [Indexed: 05/12/2023]
Abstract
Inflammatory responses arise as an outcome of tissues or organs exposure towards harmful stimuli like injury, toxic chemicals or pathogenic microorganism. It is a complex cascade of immune mechanism to overcome from tissue injury and to initiate the healing process by recruiting various immune cells, chemical mediators such as the vasoactive peptides and amines, pro-inflammatory cytokines, eicosanoids and acute-phase proteins to prevent tissue damage and ultimately complete restoration of the tissue function. The cytokines exhibits a central function in communication between the cells, inflammatory response initiation, amplification and their regulation. This review covers the importance of inflammatory responses; the significance of cytokines in inflammation and numerous inflammatory disorders/ailments due to the abrupt expression of cytokines and the hyper-inflammatory response or cytokine storm associated with poor prognosis in COVID-19 pandemic. Also highlighting the importance of naturally derived anti-inflammatory metabolites to overcome the side-effects of currently prevailing anti-inflammatory drugs.
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Affiliation(s)
- K B Megha
- Toxicology Division, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology (Govt. of India), Poojapura, Trivandrum 695012, Kerala, India
| | - X Joseph
- Toxicology Division, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology (Govt. of India), Poojapura, Trivandrum 695012, Kerala, India
| | - V Akhil
- Toxicology Division, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology (Govt. of India), Poojapura, Trivandrum 695012, Kerala, India
| | - P V Mohanan
- Toxicology Division, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology (Govt. of India), Poojapura, Trivandrum 695012, Kerala, India.
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Qian Y, Qu Y, Gao F, Pei M, Liang A, Xiao J, Zhao C, Zhang M. Comparison of the Safety and Efficacy of Interferon Alpha-2a and Cyclosporine-A When Combined With Glucocorticoid in the Treatment of Refractory Behçet's Uveitis: A Randomized Controlled Prospective Study. Front Pharmacol 2021; 12:699903. [PMID: 34349656 PMCID: PMC8326402 DOI: 10.3389/fphar.2021.699903] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 07/05/2021] [Indexed: 01/01/2023] Open
Abstract
Purpose: To evaluate and compare the efficacy and safety of interferon alpha-2a (IFN-α2a) and cyclosporine-A (CsA) in patients with refractory Behçet’s uveitis (BU). Methods: In this 12-month randomized, controlled, prospective trial, 26 participants (44 eyes) completed the study. Patients were randomly allocated to the IFN-α2a or CsA groups. All patients in both groups received a standardized prednisone burst and tapering schedule as per protocol. The primary outcome measures were response rate, complete remission rate, and tolerance rate. The secondary outcome measures included time to achieve complete remission, the logarithm of the minimum angle of resolution (logMAR) of best-corrected visual acuity (BCVA), and Behçet’s disease ocular attack score 24 (BOS24). T-tests and non-parametric tests were used to compare quantitative variables, and chi-square tests were performed to compare qualitative variables. Results: The response and complete remission rates were 85.7% (12/14 patients) and 50.0% (7/14 patients) in the IFN-α2a group, compared with 66.7% (8/12 patients) and 25.0% (3/12 patients) in the CsA group, respectively (p > 0.05). Complete remission was achieved at 3.3 and 7.0 months after initiation of IFN-α2a and CsA (p = 0.023). LogMAR BCVA significantly improved 1 month after IFN-α2a initiation (23 eyes) (p = 0.002), and this beneficial effect remained statistically significant during the entire follow-up period (p < 0.05); however, this improvement was not observed in the CsA group (21 eyes). At the endpoint, LogMAR BCVA in the IFN-α2a group was significantly better (0.22 vs. 0.31, p = 0.031) with a higher improvement rate (60.9 vs. 47.6%, p > 0.05). Moreover, compared to the CsA group, more eyes in the IFN-α2a group had a lower BOS24 score (87.0 vs. 57.1%, p = 0.042). None of the patients had any side effects that influenced the medication adherence. Conclusion: Compared to CsA plus corticosteroid, IFN-α2a plus corticosteroid appears to induce a better treatment response, a significantly greater improvement in visual acuity, and more stable remission of intraocular inflammation in a 12-month study period.
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Affiliation(s)
- Yujing Qian
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yi Qu
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fei Gao
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Minghang Pei
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Anyi Liang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Junyan Xiao
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chan Zhao
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Meifen Zhang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Uribe-Reina P, Muñoz-Ortiz J, Cifuentes-González C, Reyes-Guanes J, Terreros-Dorado JP, Zambrano-Romero W, López-Rojas C, Mantilla-Sylvain F, Mantilla-Hernández RD, de-la-Torre A. Ocular Manifestations in Colombian Patients with Systemic Rheumatologic Diseases. Clin Ophthalmol 2021; 15:2787-2802. [PMID: 34234401 PMCID: PMC8254180 DOI: 10.2147/opth.s306621] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 04/20/2021] [Indexed: 12/18/2022] Open
Abstract
PURPOSE To establish the prevalence of ocular involvement in a Colombian population with rheumatologic diseases. DESIGN Observational cross-sectional study. METHODS We included a probabilistic sample size of 797 patients who attended a rheumatologic disease center in Bogotá, Colombia. Statistical analysis with descriptive measures and Chi-square independence test between rheumatologic diseases and ophthalmological symptoms and diseases was performed. RESULTS Eighty-four percent of the population were women, and the mean age was 54.61± 15.64 years. The most common condition was rheumatoid arthritis (33.37%), followed by fibromyalgia (22.71%), Sjögren Syndrome (19.72%), and systemic lupus erythematosus (9.91%). Almost 7% of the patients presented polyautoimmunity. Thirty-five percent of the patients reported one or more ophthalmological symptoms, being dry eye sensation the most common (30.86%), followed by ocular pain (2.76%), red-eye, and decreased visual acuity (both 2.63%). Similarly, 21.45% of the patients presented one or more ophthalmological diagnoses, being keratoconjunctivitis sicca the most common (15.93%), followed by cataract, uveitis (1.38% each), and scleritis (1.25%). CONCLUSION Almost a third of the patients reported any ocular involvement. It is crucial to be aware of the most common ophthalmic manifestations among the different rheumatologic diseases in our population, to offer early specialist referral and timely treatment.
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Affiliation(s)
- Pilar Uribe-Reina
- Neuroscience Research Group “NeURos”, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
- Escuela Barraquer, Research Group, Escuela Superior de Oftalmología del Instituto Barraquer de América, Bogotá, Colombia
| | - Juliana Muñoz-Ortiz
- Neuroscience Research Group “NeURos”, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
- Escuela Barraquer, Research Group, Escuela Superior de Oftalmología del Instituto Barraquer de América, Bogotá, Colombia
| | - Carlos Cifuentes-González
- Neuroscience Research Group “NeURos”, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | - Juliana Reyes-Guanes
- Escuela Barraquer, Research Group, Escuela Superior de Oftalmología del Instituto Barraquer de América, Bogotá, Colombia
| | - Juan Pablo Terreros-Dorado
- Neuroscience Research Group “NeURos”, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | - William Zambrano-Romero
- Neuroscience Research Group “NeURos”, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
- Fundación Para la Investigación en Dermatología y Reumatología (FUNINDERMA), Bogotá, Colombia
| | - Carolina López-Rojas
- Escuela Barraquer, Research Group, Escuela Superior de Oftalmología del Instituto Barraquer de América, Bogotá, Colombia
| | - Fabien Mantilla-Sylvain
- Fundación Para la Investigación en Dermatología y Reumatología (FUNINDERMA), Bogotá, Colombia
| | | | - Alejandra de-la-Torre
- Neuroscience Research Group “NeURos”, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
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Raafat KA, Allam RSHM, Medhat BM. OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY FINDINGS IN PATIENTS WITH NONOCULAR BEHÇET DISEASE. Retina 2020; 39:1607-1612. [PMID: 29689026 DOI: 10.1097/iae.0000000000002177] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To describe the optical coherence tomography angiography findings in nonocular Behçet disease. METHODS The superficial capillary plexus (SCP) and deep capillary plexus (DCP) and outer retinal and choroidal flow were evaluated using optical coherence tomography angiography. Perimetry was performed to correlate any microvascular and functional changes. RESULTS Capillary nonperfusion areas were found in the superficial capillary plexus in 16/20 eyes (80%) and in the DCP in 17/20 eyes (85%). Perifoveal capillary arcade disruption and vessel rarefaction were present in both plexuses in all cases. Capillary telangiectasia was present in the superficial capillary plexus in five eyes (25%) and in the DCP in all eyes. Telangiectasia of the parafoveal capillaries was present in the DCP in all eyes. The mean area of the foveal avascular zone was not significantly different from that in 20 normal eyes (P = 0.68). However, mean and central subfield capillary density values were significantly lower (P < 0.001 and P < 0.005, respectively) in the Behçet disease group. Perimetry revealed central scotomata on the pattern deviation plot in 12 eyes (60%). CONCLUSION Telangiectasia of the parafoveal capillaries was detected in the DCP in all cases. Microvascular changes in the superficial capillary plexus and DCP in nonocular Behçet disease can be detected by optical coherence tomography angiography.
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Affiliation(s)
- Karim A Raafat
- Departments of Ophthalmology, Faculty of Medicine, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Riham S H M Allam
- Departments of Ophthalmology, Faculty of Medicine, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Basma M Medhat
- Department of Rheumatology and Rehabilitation, Faculty of Medicine, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt
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Mesgari S, Nazm SA, Bonyadi M, Jabbarpoor Bonyadi MH, Soheilian M. Paroxonase (PON1-L55M) gene polymorphism and its association with Behçet's disease among Iranian population. Ophthalmic Genet 2020; 41:293-294. [PMID: 32326787 DOI: 10.1080/13816810.2020.1747087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Samaneh Mesgari
- Department of Biology, School of Genetic, Azad University of Tabriz , Tabriz, Iran
| | - Saba A Nazm
- Center of Excellence for Biodiversity, Faculty of Natural Sciences, University of Tabriz , Tabriz, Iran
| | - Mortaza Bonyadi
- Center of Excellence for Biodiversity, Faculty of Natural Sciences, University of Tabriz , Tabriz, Iran
| | | | - Masoud Soheilian
- Ocular Tissue Engineering Research Center, Ophthalmic Research Center, Shahid Beheshti Universith of Medical Sciences , Tehran, Iran
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13
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Allam RSHM, Medhat BM. A Clinical Audit on the Predictors for Visual Morbidity in Patients with Behçet's Disease Attending Cairo University Hospitals. Semin Ophthalmol 2020; 35:149-155. [PMID: 32475197 DOI: 10.1080/08820538.2020.1772318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To study the visual disability predictors in Behçet's disease (BD). METHODS A cross-sectional observational study including 54 patients. Sociodemographic and cumulative clinical characteristics were obtained. Ophthalmic examination focused on disease activity and degree of visual loss. RESULTS Presenting features included oral ulcers, orogenital ulcers, uveitis, and vascular involvement. Ocular involvement was also present in a majority of the cases 74.1%. The age at onset had no significant effect on diagnostic time lag (P = .9), unlike rural residency (P = .02). Laterality, ocular activity, and interventions significantly affected final visual acuity (P˂0.001). A diagnostic time lag ≥ 9 months significantly affected final visual acuity (P = .039). CONCLUSION BD is associated with considerable vision loss at a young age. Panuveitis, bilaterality, ocular activity, and interventions are significant predictors. A diagnostic time lag ≥ 9 months is associated with poor visual outcomes and is significantly associated with rural residency.
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Affiliation(s)
- Riham S H M Allam
- Department of Ophthalmology, Faculty of Medicine, Kasr Al Ainy School of Medicine, Cairo University , Cairo, Egypt
| | - Basma M Medhat
- Department of Rheumatology and Rehabilitation, Faculty of Medicine, Kasr Al Ainy School of Medicine, Cairo University , Cairo, Egypt
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Auluck I, Karimi A, Taylor S. Lessons of the month 2: A case of Behçet's disease: 70% have ophthalmic involvement. Clin Med (Lond) 2019; 19:519-522. [PMID: 31732597 PMCID: PMC6899251 DOI: 10.7861/clinmed.2019.0149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A 34-year-old man presented to the emergency department with acute painless loss of vision of the left eye. Past medical history included painful lumps in the legs and frequent mouth ulcers, which were undiagnosed. The patient's visual acuity was 6/5 and counting fingers in the right and left eye, respectively. There were extensive intraretinal haemorrhages and venous sheathing in the superior quadrant of the left eye with associated disc oedema. The case was discussed in a multidisciplinary team meeting in the presence of ophthalmology, dermatology and immunology and a diagnosis of Behçet's disease was reached. The patient was commenced on intravenous methylprednisolone for 3 days followed by a switch to oral prednisolone. Due to recalcitrant uveitis, an intravitreal dexamethasone implant was administered. Eventually, systemic azathioprine and infliximab were commenced with frequent review by ophthalmology and immunology. The macular oedema improved but, unfortunately, the patient's visual acuity did not recover. Behçet's disease is a complex vasculitis involving multiple organ systems. Ocular manifestations can occur in 70% of patients, comprising retinal vasculitis, anterior uveitis, iridocyclitis, chorioretinitis, scleritis, keratitis, vitreous haemorrhage, optic neuritis, conjunctivitis, retinal vein occlusion and retinal neovascularisation. A tailored multidisciplinary approach is required, with corticosteroids being the mainstay of treatment.
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El-Garf A, Abdo M, Alkemary A, Mohamed S. Behçet’s disease patterns and subsets in a cohort of Egyptian patients. THE EGYPTIAN RHEUMATOLOGIST 2019. [DOI: 10.1016/j.ejr.2018.05.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Ghembaza MEA, Lounici A. Relationship between age at onset and clinical characteristics of Behçet’s disease. ACTA DERMATOVENEROLOGICA ALPINA PANNONICA ET ADRIATICA 2018. [DOI: 10.15570/actaapa.2018.37] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Shahriyari E, Bonyadi M, Jabbarpoor Bonyadi MH, Soheilian M, Yaseri M, Ebrahimiadib N. Ubiquitin Associated and SH3 Domain Containing B (UBASH3B) Gene Association with Behcet’s Disease in Iranian Population. Curr Eye Res 2018; 44:200-205. [DOI: 10.1080/02713683.2018.1524913] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Elham Shahriyari
- Center of Excellence for Biodiversity, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran
| | - Mortaza Bonyadi
- Center of Excellence for Biodiversity, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran
| | | | - Masoud Soheilian
- Ocular Tissue Engineering Research Center, Ophthalmic Research Center, Shahid Beheshty University of Medical Sciences, Tehran, Iran
| | - Mehdi Yaseri
- Department of Biostatistics and Epidemiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazanin Ebrahimiadib
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Science (TUMS), Tehran, Iran
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Yalcinbayir O, Caliskan E, Ucan Gunduz G, Gelisken O, Kaderli B, Yucel A. Efficacy of Dexamethasone Implants in Uveitic Macular Edema in Cases with Behçet Disease. Ophthalmologica 2018; 241:190-194. [DOI: 10.1159/000490674] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 06/06/2018] [Indexed: 11/19/2022]
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The main aspects of retinal vein occlusion etiopathogenisis in young adults. Part I. Neuroretinovasculitis (prothrombotic potential, clinical manifestations). OPHTHALMOLOGY JOURNAL 2018. [DOI: 10.17816/ov11257-67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
This review is dedicated to the neuroretinovasculitis, which is the leading cause of retinal vein occlusion in young adults. Presumed etiological factors, possible pathogenic mechanisms, and clinical manifestation are analyzed. Advisability of multidisciplinary approach in management and individual approach in treatment of patients with neuroretinovasculitis with secondary retinal vein occlusion are justified.
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Coşkun E, Celemler P, Kimyon G, Öner V, Kisacik B, Erbagci I, Onat AM. Intravitreal Dexamethasone Implant for Treatment of Refractory Behçet Posterior Uveitis: One-year Follow-up Results. Ocul Immunol Inflamm 2015; 23:437-43. [PMID: 26470764 DOI: 10.3109/09273948.2015.1042167] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To investigate the results of dexamethasone (DEX) implant in the treatment of eyes with refractory Behçet posterior uveitis. METHODS A total of 17 eyes of 12 patients with active Behçet posterior uveitis were enrolled in the study. A single intravitreal injection of DEX implant was applied to each eye. Best corrected visual acuity (BCVA), central macular thickness (CMT), vitreous haze score, and intraocular pressure (IOP) were determined, at baseline and control visits of months 1, 3, 6, and 12. RESULTS The mean BCVA was significantly increased from baseline at each control visit (all p < 0.05). The mean CMT and vitreous haze score were significantly decreased from baseline at each control visit (all p < 0.05). Three eyes showed IOP spikes requiring topical anti-glaucomatous treatment. CONCLUSIONS A single injection of DEX implant was safe and effective, as an additional treatment to systemic immunomodulatory drugs, in the treatment of refractory Behçet posterior uveitis, for a 6-month period.
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Affiliation(s)
- Erol Coşkun
- a Department of Ophthalmology , Gaziantep University Medicine School , Gaziantep , Turkey
| | - Pelin Celemler
- a Department of Ophthalmology , Gaziantep University Medicine School , Gaziantep , Turkey
| | - Gezmis Kimyon
- c Gaziantep University Medicine School, Department of Rheumatology , Gaziantep , Turkey
| | - Veysi Öner
- b Recep Tayyip Erdoğan University Medicine School, Department of Ophthalmology , Rize , Turkey , and
| | - Bunyamin Kisacik
- c Gaziantep University Medicine School, Department of Rheumatology , Gaziantep , Turkey
| | - Ibrahim Erbagci
- a Department of Ophthalmology , Gaziantep University Medicine School , Gaziantep , Turkey
| | - Ahmet Mesut Onat
- c Gaziantep University Medicine School, Department of Rheumatology , Gaziantep , Turkey
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Farouk H, Chilali KE, Said K, Sakr B, Salah H, Mahmoud G, Sorour K. Value of certain echocardiographic findings in the initial suspicion of Behçet's disease. Echocardiography 2015; 31:924-30. [PMID: 25208862 DOI: 10.1111/echo.12601] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
PURPOSE To describe the echocardiographic findings detected as first manifestations of Behçet's disease (BD) and compare these findings with those detected in established cases of BD receiving regular medical treatment. METHODS Two groups of patients were studied. Group 1 comprised 41 patients with BD on regular medical treatment. Group 2 comprised 5 previously healthy patients who presented to the cardiology department because of cardiac symptoms and were diagnosed in retrospect during hospitalization as BD. Thirty-two age- and sex-matched individuals served as control subjects (control group). All patients and controls underwent complete M-mode, two-dimensional, and Doppler transthoracic echocardiographic examinations. RESULTS Of the 41 treated patients with BD (mean age: 32 ± 8 years, 90% males, mean duration since diagnosis: 14.5 years), only 1 patient was found to have severe aortic regurgitation secondary to aortic root dilation. On the other hand, the 5 previously healthy patients who presented with cardiac symptoms (mean age: 24 ± 6 years, all males) had significant cardiac involvement and evident echocardiographic findings (P < 0.001). Four cases had intracardiac masses: 3 in the right atrium (RA), 1 in the right ventricle (RV), while the last patient had pericardial effusion (PE). All these patients were diagnosed in retrospect as BD. The RA masses disappeared on medical therapy, while the RV mass was surgically excised and proved to be multiple thrombi histopathologically. The patient with PE had recurrent attacks of massive effusion so a pericardial window was performed surgically. CONCLUSION Diagnosis of BD might be initially suspected by the cardiologists based on certain echocardiographic findings, namely the presence of right-sided masses. Diagnosis of BD in such patients has important therapeutic implications and accordingly prognostic value.
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Affiliation(s)
- Heba Farouk
- Cardiovascular Medicine Department, Cairo University Hospital, Cairo, Egypt
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Baş Y, Güney G, Uzbay P, Zobacı E, Ardalı S, Özkan AT. Colon perforation and Budd-Chiari syndrome in Behçet's disease. AMERICAN JOURNAL OF CASE REPORTS 2015; 16:262-7. [PMID: 25934795 PMCID: PMC4428319 DOI: 10.12659/ajcr.892757] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Behçet's disease is a chronic inflammatory disease involving multiple systems, with vasculitis being the most important pathological feature. Multiple colon perforations are thought to be secondary to vasculitis and they occur in patients with ulcers. These may be encountered within the entire colon but most commonly in the ileocecal region. Intestinal perforation and Budd-Chiari syndrome are infrequent in Behçet's disease, and are associated with high mortality and morbidity. Budd-Chiari syndrome results from occlusion of either hepatic veins or adjacent inferior vena cava, or both. CASE REPORT We report a patient with Behçet's disease having multiple perforations in the transverse colon, descending colon, and sigmoid colon. The patient also had Budd-Chiari syndrome due to inferior vena cava thrombosis extending into the right and middle hepatic vein. Our observations are presented with a review of the literature. CONCLUSIONS In Behçet's disease, treatment of colon perforation necessitates urgent surgery, whereas management of Budd-Chiari syndrome is directed towards the underlying cause. Behçet's disease, as a chronic multisystemic disease with various forms of vasculitis, is resistant to medical and surgical treatment. Prognosis is worse in Behçet's disease with colon perforation than that in Budd-Chiari syndrome alone.
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Affiliation(s)
- Yılmaz Baş
- Department of Pathology, Hitit University, Faculty of Medicine, Çorum, Turkey
| | - Güven Güney
- Department of Pathology, Hitit University, Faculty of Medicine, Çorum, Turkey
| | - Pınar Uzbay
- Department of Pathology, Hitit University, Faculty of Medicine, Çorum, Turkey
| | - Ethem Zobacı
- Department of General Surgery, Hitit University, Faculty of Medicine, Çorum, Turkey
| | - Selin Ardalı
- Department of Radiology, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Ayşegül Taylan Özkan
- Department of Microbiology, Hitit University, Faculty of Medicine, Çorum, Turkey
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Turner MD, Nedjai B, Hurst T, Pennington DJ. Cytokines and chemokines: At the crossroads of cell signalling and inflammatory disease. BIOCHIMICA ET BIOPHYSICA ACTA-MOLECULAR CELL RESEARCH 2014; 1843:2563-2582. [PMID: 24892271 DOI: 10.1016/j.bbamcr.2014.05.014] [Citation(s) in RCA: 1316] [Impact Index Per Article: 131.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 05/22/2014] [Accepted: 05/23/2014] [Indexed: 12/14/2022]
Abstract
Inflammation occurs as a result of exposure of tissues and organs to harmful stimuli such as microbial pathogens, irritants, or toxic cellular components. The primary physical manifestations of inflammation are redness, swelling, heat, pain, and loss of function to the affected area. These processes involve the major cells of the immune system, including monocytes, macrophages, neutrophils, basophils, dendritic cells, mast cells, T-cells, and B-cells. However, examination of a range of inflammatory lesions demonstrates the presence of specific leukocytes in any given lesion. That is, the inflammatory process is regulated in such a way as to ensure that the appropriate leukocytes are recruited. These events are in turn controlled by a host of extracellular molecular regulators, including members of the cytokine and chemokine families that mediate both immune cell recruitment and complex intracellular signalling control mechanisms that characterise inflammation. This review will focus on the role of the main cytokines, chemokines, and their receptors in the pathophysiology of auto-inflammatory disorders, pro-inflammatory disorders, and neurological disorders involving inflammation.
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Affiliation(s)
- Mark D Turner
- Interdisciplinary Biomedical Research Centre, School of Science and Technology, Nottingham Trent University, Clifton, Nottingham NG11 8NS, United Kingdom.
| | - Belinda Nedjai
- Leukocyte Biology Section, National Heart and Lung Institute, Imperial College, South Kensington, London SW7 2AZ, United Kingdom
| | - Tara Hurst
- Interdisciplinary Biomedical Research Centre, School of Science and Technology, Nottingham Trent University, Clifton, Nottingham NG11 8NS, United Kingdom
| | - Daniel J Pennington
- Blizard Institute, Barts and The London School of Medicine, Queen Mary University of London, Whitechapel, London E1 2AT, United Kingdom
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