Recurrent versus non-recurrent or no eye involvement in Behcet's disease.

PURPOSE: The aim of this study was to note the clinical features of patients with Behçet's disease who did not show recurrent episodes of eye involvement during long-term follow-up. METHODS: A retrospective review was made of 70 Japanese patients with Behçet's disease who were seen during a 23-year period from 1974 to 1996 and followed for five or more years at Okayama University Hospital. The 70 patients were divided into three groups: 36 patients with recurrent episodes of eye involvement; 13 patients with non-recurrent one-time only eye involvement; and 21 patients with no eye involvement at all during a follow-up period of five or more years. Clinical features were compared between these three groups. RESULTS: Female sex (p = 0.0263, chi-square test), young age at the onset (p = 0.0322, Kruskal-Wallis test), and genital ulceration (p = 0.0003, chi-square test) were significantly associated with the non-recurrent or no eye involvement patients. CONCLUSIONS: Female patients with onset at a young age and who show the three signs of skin lesions and oral and genital ulcerations may have non-recurrent one-time only or no eye involvement at follow-up. A better visual prognosis can be expected for these patients.

The incidence and pathology of conjunctival ulceration in Behçet's syndrome.

AIMS: To describe the results of a study of the incidence of conjunctival ulceration and its pathology as a manifestation of Behçet's syndrome. METHODS: The authors reviewed retrospectively medical charts of 152 patients with Behçet's syndrome seen at the uveitis service of Okayama University Hospital from January 1995 to December 1999. Criteria used to diagnose Behçet's syndrome in this study required the presence of oral aphthous ulceration plus any two of three other manifestations-genital ulceration, eye lesions such as iridocyclitis and uveoretinitis, or skin lesions such as erythema nodosum. The presence of conjunctival ulceration was determined in patients with Behçet's syndrome through standardised ophthalmological examinations. A biopsy of the conjunctival ulceration was performed in one patient. The incidence of conjunctival ulceration in patients with Behçet's syndrome was calculated and the clinical and pathological features of this ulceration were examined. RESULTS: Four of 152 patients (2.6%) developed conjunctival ulceration in concordance with exacerbation of their systemic symptoms. Histopathological examinations of a conjunctival biopsy specimen in one patient revealed intraepithelial and perivascular infiltration with neutrophils and lymphocytes, consistent with Behçet's syndrome. The conjunctival ulcerations of the study patients showed good response to topical corticosteroids or topical steroids plus oral colchicine. CONCLUSIONS: Conjunctival ulceration should be noted as an uncommon but possible manifestation of Behçet's syndrome. Accordingly, routine examination of the conjunctiva is recommended in patients with Behçet's syndrome, and Behçet's syndrome should be included in a list of differential diagnoses for patients with conjunctival ulcerations.

Seropositivity of human herpesvirus-8 in patients with uveitis.

PURPOSE: To explore the role of human herpesvirus-8 (HHV-8) in the pathogenesis of uveitis and other forms of ocular inflammation. METHODS: Serum antibody titers to HHV-8 were measured in 76 patients with uveitis from various causes and other types of ocular inflammation in either the acute phase, the convalescent phase, or both. RESULTS: Only one 21-year-old male patient in the convalescent phase of unilateral pars planitis showed a positive titer for HHV-8. His serum was negative for human immunodeficiency virus-1. CONCLUSIONS: Although the seropositive rate in the patient population was higher than that in the general population, the increased incidence was not statistically significant. The role of HHV-8 in the pathogenesis of intraocular inflammation appears to be limited.

Frosted branch angiitis associated with Harada disease-like manifestations recurs 10 years later.

PURPOSE: To describe a case with frosted branch angiitis occurring in association with manifestations of Harada disease. CASE: A 41-year-old man developed marked iridocyclitis, frosted branch angiitis and retinal white dots, together with serous detachment of the sensory retina in the posterior pole of both eyes. OBSERVATIONS: Fluorescein angiography demonstrated multiple retinal pigment epithelial leakage points in the early phase followed by late dye pooling in the serous detachment, consistent with the manifestations of Harada disease. The patient experienced recurrence of the same combination of manifestations 10 years later. On both occasions, he showed mononuclear cell increase and protein elevation in the cerebrospinal fluid on spinal tap. CONCLUSION: Fluorescein angiography and spinal tap supported the diagnosis of Harada disease in the patient. The present patient could be diagnosed as having either Harada disease with frosted branch-like response or frosted branch angiitis with serous retinal detachment as occurs in Harada disease.