Behçet’s Uveitis: Current Diagnostic and Therapeutic Approach
Pınar Özdal
Abstract
The disease is more common in the Mediterranean region and in Far East and Middle East countries. This geographical region falls between the 30 and 45 northern latitudes, a region that also includes the historic "Silk Road" trade route connecting the East and West and the highest HLA-B51 antigen distribution. The country with the highest incidence of BD worldwide is Turkey. The highest reported prevalence is in stanbul, at 420/100,000 population. It is much less prevalent in Europe and the United States. Even along the Mediterranean coasts of Europe, where BD is more common compared to Northern Europe, it is much rarer than in Turkey, with a reported prevalence of 2.4-7.5/100,000. D mostly affects the younger population between the ages of 25 and 35 years. The incidence in childhood is geographically variable and ranges from 4% to 26%. Although its etiopathogenesis has not yet been clarified, both the adaptive and innate immune systems, genetic predisposition, and environmental factors have all been implicated. It is more frequent and more severe in males in the third and fourth decades of life. The eye is the most frequently involved organ in the course of the disease. Ocular involvement (Behet's uveitis) is characterized by bilateral recurrent non-granulomatous panuveitis and occlusive retinal vasculitis. Recurrent inflammatory episodes in the posterior segment may lead to permanent vision loss due to irreversible retinal damage and complications such as macular scarring, macular atrophy, and optic atrophy. Early and aggressive immunomodulatory treatment and the use of biologic agents when needed are crucial for preventing recurrences and improving visual prognosis.