Uveitis in juvenile Behçet's disease: Clinical course and visual outcome compared with adult patients

Purpose: To characterize the disease course and visual outcome of uveitis in juvenile Behçet's disease (BD) compared with adults.Methods: The study population included 13 children (mean age 14±2.4 years; 22 eyes) and 16 adults (mean age 30±8.8 years; 27 eyes) with uveitis in BD diagnosed between 1997 and 2007.ResultsThe male/female ratio was 1.6:1 in the paediatric group and 3:1 in the adult group. Five children (38%) and four adults (25%) had complete BD. Mean duration of follow-up for both groups was 4.7 years. The children had more acute exacerbations (4.1±2.7 vs2.3±1.5, P=0.054). Treatment in both groups included systemic steroids and immunosuppressive agents. In children, mean initial visual acuity in the affected eyes (n22) was 0.6±0.7 logMAR (range, 0-2.2). It decreased during exacerbations in 15 eyes (68%; mean, 1.6±0.8 logMAR), severely reduced (worse than 1 logMAR) in 11 eyes (50%; mean, 2.0±0.45 logMAR), and improved significantly in 12 of 13 promptly treated eyes (92%; 6/12 or better in 11; mean 0.2±0.4 logMAR, P<0.001). The visual outcome pattern was similar in the adults.Conclusions: Uveitis in juvenile BD is characterized by frequent exacerbations of explosive nature with profoundly reduced visual acuity. Similar disease pattern was observed in children and adults, as well as in patients with complete or incomplete disease. Early diagnosis, even before all systemic criteria are fulfilled, is important because early aggressive therapy can achieve long-term useful visual acuity.