Ucar Didar, Esatoglu Sinem N
Department of Ophthalmology, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, Istanbul, Turkey.
Behçet's Disease Research Center, Istanbul University-Cerrahpaşa, Istanbul, Turkey.
Saudi J Ophthalmol. 2025 Feb 7;39(1):47-53. doi: 10.4103/sjopt.sjopt_228_24. eCollection 2025 Jan-Mar.
Behçet's uveitis (BU) is a significant form of major organ involvement in Behçet syndrome and is associated with considerable morbidity. Ocular examination is crucial for diagnosing BS and detecting vitreous cells, even in asymptomatic patients. The primary goals in managing BU are to rapidly suppress ocular inflammation and prevent relapses. Initial treatment for posterior segment involvement in BU typically involves immunosuppressive agents combined with glucocorticoids. Biologic agents are increasingly used in BU management, including as first-line treatments for patients with poor prognostic risk factors or sight-threatening uveitis. There is no established consensus on when to discontinue or taper immunosuppressive therapy. Once remission is achieved, the absence of retinal vasculitis should be confirmed with fluorescein angiography, which should be utilized throughout the process of tapering immunosuppressive therapy. In addition to monoclonal tumor necrosis factor-alpha antagonists and tocilizumab, Janus kinase inhibitors may offer the potential for managing BU in the future.
白塞氏葡萄膜炎(BU)是白塞氏综合征主要器官受累的一种重要形式,且与相当高的发病率相关。眼部检查对于诊断白塞氏综合征和检测玻璃体细胞至关重要,即使是无症状患者。治疗BU的主要目标是迅速抑制眼部炎症并预防复发。治疗BU后段受累的初始治疗通常包括免疫抑制剂联合糖皮质激素。生物制剂在BU治疗中的应用越来越多,包括作为具有不良预后风险因素或威胁视力的葡萄膜炎患者的一线治疗。关于何时停止或减停免疫抑制治疗尚无既定共识。一旦实现缓解,应通过荧光素血管造影确认视网膜血管炎的不存在,在减停免疫抑制治疗的整个过程中都应使用该检查。除了单克隆肿瘤坏死因子-α拮抗剂和托珠单抗外,Janus激酶抑制剂未来可能为治疗BU提供潜力。