Characteristics of optic neuropathy in Behçet disease

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ObjectiveWe present the clinical profile, features, and neuroimaging findings of 25 patients with Behçet disease (BD), and optic neuropathy (ON), which has been rarely reported in BD.MethodsData from 5 university hospitals were retrospectively reviewed, and patients with BD and ON were evaluated. There were 2 groups: (1) those already diagnosed with BD when ON developed (BDON group) and (2) those diagnosed with BD during the evaluation of ON (ONBD group).ResultsThere were 25 BD patients with ON (13 males). Among these, 13 had ONBD, and 12 had BDON. Seventeen patients had unilateral ON, and 7 patients had recurrent ON. BDON patients were older. Disc edema was seen more in ONBD than in BDON patients (10 vs 3). Fourteen patients also had uveitis, 7 with BDON and 7 with ON→BD. There was other neurologic involvement in 8 patients; in the BDON group, 4/4 had MS-like disease, in the ONBD group, 3 had typical parenchymal BD, and 1 had MS-like disease. Twenty of 21 patients received immunosuppressive medications, corticosteroids, or both. Prognosis was favorable in most: vision improved in 20 patients, more often in those receiving combined therapies.ConclusionBD may be diagnosed earlier if it is considered and investigated during the assessment of ON, particularly in high-risk regions. Prognosis of ON related to BD seems to be favorable. Immunosuppressants should be given along with corticosteroids. MS-like presentations should also be kept in mind in patients with BD and ON.

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