Ocular Manifestations in Late Onset Behçet’s Disease

Background: Behçet’s disease is frequent in Tunisia and potentially serious, which can endanger both the vital and visual prognosis. Late occurrence of the disease is uncommon and less frequently investigated. Aims: The aim of this study was to analyse the demographic characteristics and ocular manifestations of patients with late-onset Behçet disease in Tunisia, North Africa. Methods: A retrospective study was performed on 38 eyes of 21 oculo-Behçet patients over a seven- year period. Results: The mean age of our patients was 54.81 years. The sex ratio M/F was 2.5. The period between the onset of the first symptom and diagnosis of Behçet’s disease varied from 3 days to 2 years. The primary complaint was a decrease in visual acuity, reported in 8 patients. Ocular involvement revealed Behçet’s disease in 2 patients, bilateral in 17 patients, and active in 31 eyes. The ocular manifestations in late-onset Behçet’s disease were dominated by uveal involvement (30 eyes). The most frequent form of uveitis was panuveitis noted in 13 eyes. Ocular complications were dominated by macular involvement in 8 patients (14 eyes). Blindness was noted in 4 eyes of 4 patients (10.5%). Topical corticosteroids were used in 30 eyes. Three patients were treated only with oral corticosteroid and 9 patients with a combination of oral corticosteroid and immunosuppressive agents. Conclusion: Since the course of the ocular involvement in late-onset Behçet’s disease is regarded to be relatively mild, it is noteworthy that our study revealed that blindness was noted in 10,5% and posterior uveitis and panuveitis were the most common uveal lesion.