The Risk Factors and Causes for Blindness in Behcet’s Disease

Purpose: To investigate the risk factors and causes for blindness in Behcet’s disease (BD).Methods: In this preliminary retrospective case series we have investigated 27 BD patients (54 eyes), legally blind (vision 0.1 or less) at least in one eye at the last visit (2006), and compared them with 54 eyes of 27 non-blind patients (control group), matched individually and consequently in terms of duration of BD follow-up and treatment.Results: Eighteen (66.6%) of our blind patients were male versus thirteen (48%) of the control group (p=0.167). Low vision (0.1 or less) at the first consultation, 23 eyes (42.6%) in the blind group versus three eyes (5.6%) in the control group (p=0.001), higher number of uveitis in the main group 51 eyes (94.4%) versus 35 eyes (64.8%) in the control group (p=0.007), Longer duration of uveitis (10.3±4.8 vs. 5.1±3.97years, p 0.001), longer duration of retinal vacuities (10.9±5.1 vs. 5.6±3.7 years, p 0.001) in the blind group under investigation were the four major risk factors in the poor outcome of ocular disease, P≤0.000 in all cases. At the last visit 42 eyes (77.8%) of the main group were legally blind. The main cause of blindness was chorioretinal vasculitis in 32 eyes (20 patients), and its consequences: optic atrophy, macular scar, chorioretinal atrophy and vascular necrosis. In ten remaining blind eyes the causes for impaired vision were: 3 retinal detachments, 3 optic atrophies ± macular scars, 1 macular scar, 1 macular and disc edema, 1 phthisis bulbi, 1 disc neovascularization and vitreous hemorrhage.Conclusion: Higher frequency of uveitis and longer duration of uveitis and retinal vasculitis, and also the initial low vision at the presentation were the main blinding risk factors and the main cause of blindness was retinal vasculitis and its consequences