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Ostrovsky M, Ramon D, Iriqat S, Shteiwi A, Sharon Y, Kramer M, Vishnevskia-Dai V, Sar S, Boulos Y, Tomkins-Netzer O, Lavee N, Ben-Arie-Weintrob Y, Pizem H, Hareuveni-Blum T, Schneck M, Gepstein R, Masarwa D, Nakhoul N, Bakshi E, Shulman S, Goldstein M, Anouk M, Rosenblatt A, Habot-Wilner Z. Retinal vascular occlusions in ocular Behçet disease - a comparative analysis. Acta Ophthalmol 2023. [PMID: 36750991 DOI: 10.1111/aos.15645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/08/2023] [Accepted: 01/22/2023] [Indexed: 02/09/2023]
Abstract
PURPOSE The literature on retinal vascular occlusions in Behçet disease (BD) patients is limited. The aim of this study is to thoroughly investigate retinal vascular occlusions among ocular BD patients. METHODS Retrospective, multicentre case-control study. Three-hundred and three eyes of 175 patients with ocular BD, from 13 hospitals in Israel and Palestine, were included. Patients were assigned into two groups according to the presence of retinal vascular occlusion. Epidemiology, systemic and ocular manifestations, treatments and outcomes were compared between the groups and risk factors for retinal vascular occlusions were identified. RESULTS One hundred twenty-five patients (71.4%) were male. The mean age at presentation was 28.2 ± 0.86 years. Retinal vascular occlusions were found in 80 eyes of 54 (30.9%) patients, including branch retinal vein occlusion (51.3%), peripheral vessels occlusions (32.5%), central retinal vein occlusion (13.8%) and arterial occlusions (7.5%). Systemic manifestations were similar among both groups. Anterior uveitis was more common in non-occlusive eyes (p < 0.01). Non-occlusive retinal vasculitis (p = 0.03) and ocular complications were more common in occlusive eyes (p < 0.01). Treatments including mycophenolate mofetil, Infliximab or a combination therapy of anti-metabolite and calcineurin inhibitor were more commonly used by occlusive patients (p < 0.05). Occlusive patients underwent more cataract surgeries (p = 0.03). The occlusive group had worse mean best-corrected visual acuity (BCVA) throughout follow-up (p < 0.01). Risk factors for retinal vascular occlusions included male sex and Jewish ethnicity (p < 0.05). CONCLUSION Retinal vascular occlusions were found in a third of ocular BD patients. Occlusive eyes had a worse prognosis. Risk factors for vascular occlusions were identified.
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Affiliation(s)
| | - Dan Ramon
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Salam Iriqat
- St. John of Jerusalem Eye Hospital Group, East Jerusalem, Palestine
| | - Abdallah Shteiwi
- St. John of Jerusalem Eye Hospital Group, East Jerusalem, Palestine
| | - Yael Sharon
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Ophthalmology, Rabin Medical Center, Petah-Tikva, Israel
| | - Michal Kramer
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Ophthalmology, Rabin Medical Center, Petah-Tikva, Israel
| | - Vicktoria Vishnevskia-Dai
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Goldschleger Eye Institute, Department of Ophthalmology, Sheba Medical Center, Ramat-Gan, Israel
| | - Shaul Sar
- Department of Ophthalmology, Carmel Medical Center, The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Yosif Boulos
- Department of Ophthalmology, Carmel Medical Center, The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Oren Tomkins-Netzer
- Department of Ophthalmology, Carmel Medical Center, The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Natalie Lavee
- Department of Ophthalmology, HaEmek Medical Center, The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Yael Ben-Arie-Weintrob
- Department of Ophthalmology, Rambam Medical Center, The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Hadas Pizem
- Department of Ophthalmology, Rambam Medical Center, The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Tamar Hareuveni-Blum
- Department of Ophthalmology, Galilee Medical Center, Azrieli Faculty of Medicine, Bar-Ilan University, Nahariya, Israel
| | - Marina Schneck
- Department of Ophthalmology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Raz Gepstein
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel
| | - Dua Masarwa
- Department of Ophthalmology, Barzilai Medical Center, Ashkelon, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel
| | - Nakhoul Nakhoul
- Department of Ophthalmology, Baruch Padeh Medical Center, Azrieli Faculty of Medicine, Bar-Ilan University, Tiberias, Israel
| | - Erez Bakshi
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Ophthalmology, Assaf Harofeh Medical Center, Zerifin, Israel
| | - Shiri Shulman
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Department of Ophthalmology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Michaella Goldstein
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Marina Anouk
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Institute of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Amir Rosenblatt
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Zohar Habot-Wilner
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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