Ocular Inflammation in Behçet Disease: Incidence of Ocular Complications and of Loss of Visual Acuity

R. Oktay Kaçmaz, John H. Kempen, Craig Newcomb, Sapna Gangaputra, Ebenezer Daniel, Grace A. Levy-Clarke, Robert B. Nussenblatt, James (Jim) Rosenbaum, Eric Suhler, Jennifer E. Thorne, Douglas A. Jabs, C. Stephen Foster

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Abstract

Purpose: To estimate the risk of structural ocular complications and loss of visual acuity (VA) in cases of Behçet disease (BD) and to evaluate potential risk and protective factors for these events. Design: Retrospective cohort study. Methods: A total of 168 consecutive patients with BD-associated ocular inflammation treated at five academic center ocular inflammation subspecialty practices were included. Clinical data for these patients were ascertained by standardized chart review. Main outcome measures included VA, structural ocular complications of inflammation, and intraocular pressure (IOP). Results: Over a median follow-up of 1.05 years, the incidence of specific structural complications and IOP disturbances were common: the incidence rate of any ocular complication was 0.45 per eye-year (EY). Rates of loss of VA to 20/50 or worse and to 20/200 or worse were 0.12 per EY and 0.09 per EY, respectively. Risk factors for loss of VA during follow-up were persistent inflammatory activity, presence of posterior synechiae, presence of hypotony, and presence of elevated IOP. In a time-dependent analysis, current activity of ocular inflammation was associated with an increased risk of loss of VA to 20/50 or worse (relative risk [RR], 2.45; 95% confidence interval [CI], 1.1 to 5.5; P = .03) and to 20/200 or worse (RR, 2.67; 95% CI, 1.2 to 5.8; P = .01). Conclusions: Loss of VA and occurrence of ocular complications were common in patients with ocular inflammation associated with BD, even with aggressive therapy. Ongoing inflammation during follow-up, presence or occurrence of posterior synechiae, hypotony, and elevated IOP were associated with an increased risk of loss of VA.

Original languageEnglish (US)
Pages (from-to)828-836
Number of pages9
JournalAmerican Journal of Ophthalmology
Volume146
Issue number6
DOIs
StatePublished - Dec 2008

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Visual Acuity
Inflammation
Incidence
Intraocular Pressure
Confidence Intervals
Cohort Studies
Retrospective Studies
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Kaçmaz, R. O., Kempen, J. H., Newcomb, C., Gangaputra, S., Daniel, E., Levy-Clarke, G. A., ... Foster, C. S. (2008). Ocular Inflammation in Behçet Disease: Incidence of Ocular Complications and of Loss of Visual Acuity. American Journal of Ophthalmology, 146(6), 828-836. https://doi.org/10.1016/j.ajo.2008.06.019

Ocular Inflammation in Behçet Disease : Incidence of Ocular Complications and of Loss of Visual Acuity. / Kaçmaz, R. Oktay; Kempen, John H.; Newcomb, Craig; Gangaputra, Sapna; Daniel, Ebenezer; Levy-Clarke, Grace A.; Nussenblatt, Robert B.; Rosenbaum, James (Jim); Suhler, Eric; Thorne, Jennifer E.; Jabs, Douglas A.; Foster, C. Stephen.

In: American Journal of Ophthalmology, Vol. 146, No. 6, 12.2008, p. 828-836.

Research output: Contribution to journalArticle

Kaçmaz, RO, Kempen, JH, Newcomb, C, Gangaputra, S, Daniel, E, Levy-Clarke, GA, Nussenblatt, RB, Rosenbaum, JJ, Suhler, E, Thorne, JE, Jabs, DA & Foster, CS 2008, 'Ocular Inflammation in Behçet Disease: Incidence of Ocular Complications and of Loss of Visual Acuity', American Journal of Ophthalmology, vol. 146, no. 6, pp. 828-836. https://doi.org/10.1016/j.ajo.2008.06.019
Kaçmaz, R. Oktay ; Kempen, John H. ; Newcomb, Craig ; Gangaputra, Sapna ; Daniel, Ebenezer ; Levy-Clarke, Grace A. ; Nussenblatt, Robert B. ; Rosenbaum, James (Jim) ; Suhler, Eric ; Thorne, Jennifer E. ; Jabs, Douglas A. ; Foster, C. Stephen. / Ocular Inflammation in Behçet Disease : Incidence of Ocular Complications and of Loss of Visual Acuity. In: American Journal of Ophthalmology. 2008 ; Vol. 146, No. 6. pp. 828-836.
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abstract = "Purpose: To estimate the risk of structural ocular complications and loss of visual acuity (VA) in cases of Beh{\cc}et disease (BD) and to evaluate potential risk and protective factors for these events. Design: Retrospective cohort study. Methods: A total of 168 consecutive patients with BD-associated ocular inflammation treated at five academic center ocular inflammation subspecialty practices were included. Clinical data for these patients were ascertained by standardized chart review. Main outcome measures included VA, structural ocular complications of inflammation, and intraocular pressure (IOP). Results: Over a median follow-up of 1.05 years, the incidence of specific structural complications and IOP disturbances were common: the incidence rate of any ocular complication was 0.45 per eye-year (EY). Rates of loss of VA to 20/50 or worse and to 20/200 or worse were 0.12 per EY and 0.09 per EY, respectively. Risk factors for loss of VA during follow-up were persistent inflammatory activity, presence of posterior synechiae, presence of hypotony, and presence of elevated IOP. In a time-dependent analysis, current activity of ocular inflammation was associated with an increased risk of loss of VA to 20/50 or worse (relative risk [RR], 2.45; 95{\%} confidence interval [CI], 1.1 to 5.5; P = .03) and to 20/200 or worse (RR, 2.67; 95{\%} CI, 1.2 to 5.8; P = .01). Conclusions: Loss of VA and occurrence of ocular complications were common in patients with ocular inflammation associated with BD, even with aggressive therapy. Ongoing inflammation during follow-up, presence or occurrence of posterior synechiae, hypotony, and elevated IOP were associated with an increased risk of loss of VA.",
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T1 - Ocular Inflammation in Behçet Disease

T2 - Incidence of Ocular Complications and of Loss of Visual Acuity

AU - Kaçmaz, R. Oktay

AU - Kempen, John H.

AU - Newcomb, Craig

AU - Gangaputra, Sapna

AU - Daniel, Ebenezer

AU - Levy-Clarke, Grace A.

AU - Nussenblatt, Robert B.

AU - Rosenbaum, James (Jim)

AU - Suhler, Eric

AU - Thorne, Jennifer E.

AU - Jabs, Douglas A.

AU - Foster, C. Stephen

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N2 - Purpose: To estimate the risk of structural ocular complications and loss of visual acuity (VA) in cases of Behçet disease (BD) and to evaluate potential risk and protective factors for these events. Design: Retrospective cohort study. Methods: A total of 168 consecutive patients with BD-associated ocular inflammation treated at five academic center ocular inflammation subspecialty practices were included. Clinical data for these patients were ascertained by standardized chart review. Main outcome measures included VA, structural ocular complications of inflammation, and intraocular pressure (IOP). Results: Over a median follow-up of 1.05 years, the incidence of specific structural complications and IOP disturbances were common: the incidence rate of any ocular complication was 0.45 per eye-year (EY). Rates of loss of VA to 20/50 or worse and to 20/200 or worse were 0.12 per EY and 0.09 per EY, respectively. Risk factors for loss of VA during follow-up were persistent inflammatory activity, presence of posterior synechiae, presence of hypotony, and presence of elevated IOP. In a time-dependent analysis, current activity of ocular inflammation was associated with an increased risk of loss of VA to 20/50 or worse (relative risk [RR], 2.45; 95% confidence interval [CI], 1.1 to 5.5; P = .03) and to 20/200 or worse (RR, 2.67; 95% CI, 1.2 to 5.8; P = .01). Conclusions: Loss of VA and occurrence of ocular complications were common in patients with ocular inflammation associated with BD, even with aggressive therapy. Ongoing inflammation during follow-up, presence or occurrence of posterior synechiae, hypotony, and elevated IOP were associated with an increased risk of loss of VA.

AB - Purpose: To estimate the risk of structural ocular complications and loss of visual acuity (VA) in cases of Behçet disease (BD) and to evaluate potential risk and protective factors for these events. Design: Retrospective cohort study. Methods: A total of 168 consecutive patients with BD-associated ocular inflammation treated at five academic center ocular inflammation subspecialty practices were included. Clinical data for these patients were ascertained by standardized chart review. Main outcome measures included VA, structural ocular complications of inflammation, and intraocular pressure (IOP). Results: Over a median follow-up of 1.05 years, the incidence of specific structural complications and IOP disturbances were common: the incidence rate of any ocular complication was 0.45 per eye-year (EY). Rates of loss of VA to 20/50 or worse and to 20/200 or worse were 0.12 per EY and 0.09 per EY, respectively. Risk factors for loss of VA during follow-up were persistent inflammatory activity, presence of posterior synechiae, presence of hypotony, and presence of elevated IOP. In a time-dependent analysis, current activity of ocular inflammation was associated with an increased risk of loss of VA to 20/50 or worse (relative risk [RR], 2.45; 95% confidence interval [CI], 1.1 to 5.5; P = .03) and to 20/200 or worse (RR, 2.67; 95% CI, 1.2 to 5.8; P = .01). Conclusions: Loss of VA and occurrence of ocular complications were common in patients with ocular inflammation associated with BD, even with aggressive therapy. Ongoing inflammation during follow-up, presence or occurrence of posterior synechiae, hypotony, and elevated IOP were associated with an increased risk of loss of VA.

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