Etiology, systemic symptoms, ophthalmic symptoms (uveitis, retinal vasculitis), diagnostic criteria, treatment, and prognosis of Behcet's disease

👁 Behcet’s Disease – Systemic Autoimmune Disease with Ocular Involvement

Behcet’s disease is a multisystem inflammatory disorder
associated with HLA-B51 and potential triggers like HSV or heat-shock proteins.
Its hallmark is recurrent oral ulcers, but it also affects the eyes, skin, vasculature, CNS, and GI tract.

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✅ Diagnostic Criteria

SystemCriteria

Japan	Major (oral, genital ulcers, skin, eye) + minor criteria → Complete or Incomplete
ISG (International Study Group)	3+ oral ulcers/year + 2 of genital ulcers, eye lesions, skin, pathergy test

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✅ Systemic Manifestations

SystemFeature

Oral	Painful ulcers, most common
Genital	May scar
Skin	Erythema nodosum, acneiform lesions
GI	Ileocecal ulcers
Vascular	Venous thrombosis > arterial (pulmonary aneurysm rare but fatal)
CNS	Meningoencephalitis, cranial nerve palsies

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✅ Ocular Involvement

SiteFindings

Anterior	Hypopyon uveitis, often without conjunctival injection (Cold hypopyon)
Posterior	Retinal vasculitis, vascular occlusion, CNV, optic atrophy, RD

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✅ Treatment Summary

• Steroids (topical/systemic)
• Cyclosporine / Tacrolimus – for T-cell suppression
• Immunomodulators: MTx, Azathioprine, Infliximab
• Colchicine / Thalidomide – mucocutaneous lesions

Thalidomide: strictly contraindicated in women of childbearing potential

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✅ Prognosis

• Many patients lead normal lives with treatment
• Visual prognosis depends on early detection of ocular Behcet’s
• 10-year disease activity tends to decline naturally