Long-Term Outcomes of Uveoretinitis in Behçet's Disease in the Era of Biologic Treatments: A 10-Year Follow-Up Study.

Abstract

Purpose: Treatment with biologics such as infliximab (IFX) for Behçet's Disease (BD) with uveoretinitis refractory to other existing therapies is well established. However, although some patients have maintained or improved their vision with IFX, other patients can manage without biologics. In this study, we investigated the demographics, clinical features, treatment of uveoretinitis, and outcomes of patients with BD uveoretinitis who were followed long-term with or without treatment with biologics.

Methods: This study included 38 patients diagnosed with BD uveoretinitis followed for more than 10 years since treatment initiation. Using data extracted from medical records, we evaluated best-corrected visual acuity, medical and surgical treatments, Behçet's Disease Ocular Attack Score 24 (BOS24), and extraocular symptoms during observation for more than 10 years.

Results: The mean BCVA was 0.25 logMAR at the first visit and 0.33 logMAR after 10-year follow-up, with no significant difference. Biologics were initiated in one-half of the patients, while the other half were managed with colchicine or steroid eye drops alone. The mean BCVA remained stable at 0.33 logMAR in patients treated with biologics, and changed from 0.17±0.33 to 0.32±0.60 logMAR in those untreated with biologics. Both groups showed improvements in ocular inflammatory attacks and extraocular symptoms over 10 years.

Conclusion: While biologic therapies, particularly TNF inhibitors, play an important role in managing refractory cases of BD uveoretinitis, our study suggests that conventional therapies such as colchicine may also provide effective long-term disease control. This highlights the importance of individualized treatment decisions, factoring in both medical and economic considerations.