Evaluation and comparison of microperimetry and optical coherence tomography findings in patients with Behçet uveitis.

PURPOSE: To evaluate and compare the findings of MP and OCT in patients with inactive Behçet's uveitis (BU). METHODS: Sixty-five eyes of 38 patients were included in this retrospective study. Ophthalmologic examination findings and OCT and MP results were recorded. The relationship between best corrected visual acuity (BCVA), duration of uveitis, central macular thickness (CMT), presence of photoreceptor zone (PZ), and/or retinal pigment epithelium (RPE) damage, macular integrity index, mean threshold and fixation stability was analyzed. RESULTS: There was a positive correlation between BCVA and CMT (p < 0.001). The eyes with PZ and/or RPE damage had significantly lower visual acuity (p < 0.001). There was a negative correlation between BCVA and macular integrity index (p = 0.005). BCVA showed positive correlations with mean threshold and fixation stability [(BCVA vs. mean threshold, p < 0.001), (BCVA vs. P1, p < 0.001), and (BCVA vs. P2, p < 0.001)]. While there was no significant correlation between CMT and macular integrity index (p = 0.08), both mean threshold and fixation stability were significantly positively correlated with CMT [(CMT vs. mean threshold, p = 0.01), (CMT vs. P1, p = 0.008), and (CMT vs. P2, p = 0.005)]. Mean threshold and fixation stability (P1 and P2) were significantly lower in the eyes with PZ and/or RPE damage (p = 0.008, p = 0.02, and p = 0.01, respectively). CONCLUSION: MP showed results consistent with visual acuity and morphological findings by OCT in patients with inactive BU. Although MP is promising for patient follow-up, controlled prospective studies are needed.

Are optical coherence tomography and fluorescein angiography comparable for detection of macular edema in Behçet uveitis?

PURPOSE: To investigate the role and agreement of spectral domain optical coherence tomography (SD-OCT) and fluorescein angiography (FA) for macular edema (ME) diagnosis in Behçet uveitis (BU). METHODS: Eyes with ME detected by SD-OCT and/or FA were enrolled. Type of ME by SD-OCT and grade of macular leakage (ML) by FA were investigated. Eyes were divided into three groups according to the agreement of tests. Three groups and factors that could affect the compatibility of tests were statistically analyzed. RESULTS: Sixty-one eyes of 61 patients were included. Both imaging methods detected ME in 42.6% of eyes (group 1). In 47.5% of eyes, ME was revealed by OCT (group 2). The remaining 9.8% of the eyes had ME, detected only by FA (group 3). Grade 2 ML by FA was more common in group 1 (p = 0.01). The grade of ML by FA was similar in groups 2 and 3. In group 2, most of the eyes showed diffuse ME by OCT (p < 0.001). Epiretinal membrane was detected more frequently in group 3 (p = 0.005). Duration and activity of uveitis were similar between groups. CONCLUSION: SD-OCT was able to detect ME in 90% of the eyes with BU. Duration and activity of uveitis were not related to the compatibility of imaging methods.

Macular structural changes and factors affecting final visual acuity in patients with Behçet uveitis.

PURPOSE: To evaluate macular structural changes during the active and remission periods in patients with Behçet uveitis and to further assess the factors affecting final visual acuity. METHODS: Clinical records and spectral domain-optical coherence tomography (SD-OCT) findings of patients with Behçet uveitis were retrospectively reviewed. RESULTS: Sixty-nine eyes of 35 patients were included in the study. SD-OCT findings in the active uveitis period included epiretinal membrane (ERM) in 26 (37.1%) eyes, ellipsoid zone (EZ) damage in 11 (15.7%), external limiting membrane (ELM) damage in 10 (14.3%), macular atrophy in 6 (8.6%), disruption of retinal pigment epithelium (RPE) in 11 (15.7%), a macular scar in 1 (1.4%), and loss of normal foveal contour appearance in 15 (21.4%). There was macular edema in 23 eyes (32.9%) in the active uveitis period (11 (15.7%) cystoid macular edema, 10 (14.3%) diffuse macular edema, and 7 (10.0%) serous retinal detachment). In the remission period, SD-OCT findings included ERM in 37 (52.9%) eyes, EZ damage in 14 (20%), ELM damage in 14 (20%), macular atrophy in 7 (10%), disruption of RPE in 14 (20.0%), macular scar in 1 (1.4%), and loss of normal foveal contour appearance in 17 (24.3%). The mean central macular thickness in the remission period was significantly lower than in the active uveitis period (p < 0.001). The presence of EZ damage and loss of normal foveal contour appearance in active uveitis period were the independent factors associated with final visual acuity (logMAR) (ß = 0.736, p = 0.003; ß = 0.682, p = 0.002, respectively). CONCLUSION: Ellipsoid zone damage and loss of normal foveal contour appearance are important factors affecting visual acuity in Behçet uveitis.

Spectral domain optical coherence tomography findings of patients with pars planitis and risk factors affecting visual acuity.

PURPOSE: To evaluate spectral domain optical coherence tomography (SD-OCT) findings of 42 eyes with pars planitis and to identify risk factors affecting visual acuity. METHODS: Medical records and SD-OCT findings were retrospectively reviewed. RESULTS: Mean best-corrected visual acuity (BCVA) was 0.248 ± 0.3 on the logMAR scale at baseline. SD-OCT findings included epiretinal membrane (ERM) in 16 (38.1%) eyes, loss of normal foveal contour appearance in 8 (19.0%), ellipsoid zone (EZ) damage in 5 (11.9%), external limiting membrane (ELM) damage in 3 (7.1%), disruption of retinal pigment epithelium (RPE) in 2 (4.8%), and macular atrophy in 1 (2.4%). There was macular edema in 10 (23.8%) eyes [cystoid macular edema (CME) in 8 (19.0%), diffuse macular edema (DME) in 6 (14.3%), and serous retinal detachment in 2 (4.8%)]. The mean central macular thickness (CMT) was 272.1 ± 319.5 µm. Patients were followed up for a mean of 50.6 ± 36.7 months. Mean BCVA was 0.210 ± 0.3 at the final evaluation. SD-OCT findings included ERM in 28 (66.7%) eyes, EZ damage in 6 (14.3%), ELM damage in 3 (7.1%), disruption of RPE in 4 (9.5%), loss of normal foveal contour appearance in 12 (28.6%), and macular atrophy in 2 (4.8%). There was CME and/or DME in 6 (14.3%) eyes. The mean CMT was 238 ± 220.9 µm and was significantly lower than the baseline (p < 0.001). According to multivariate linear regression analysis, the presence of DME, and loss of normal foveal contour appearance at baseline were the independent factors associated with BCVA at the final examination (B = 0.726, p < 0.001; B = 0.766, p < 0.001, respectively). CONCLUSIONS: DME and loss of normal foveal contour appearance were more likely to have adverse effects on visual acuity.

The relationship between serum levels of angiogenin, bFGF, VEGF, and ocular involvement in patients with Behçet's disease.

OBJECTIVES: The aim of this study was to investigate the possible role of angiogenin, vascular endothelial growth factor, (VEGF) and basic fibroblast growth factor (bFGF) in the pathogenesis of BD. DESIGN AND METHODS: Sixty-five patients with BD and 21 healthy control subjects were included in the study, and serum angiogenin, bFGF, and VEGF concentrations were measured by using in-vitro enzyme immunoassay (ELISA) kits according to the manufacturer's instructions. RESULTS: The median serum angiogenin level was significantly higher in patients with BD (391.8; range:151.6-594.8 pg/ml) than controls (298.8; range:241.9-449.6 pg/ml) (p = 0.001). The levels were similar in both ocular and non-ocular BD patients (p = 0.537). The mean serum bFGF level was higher in patients with BD (38.8 ± 12.3 pg/ml) than controls (33.2 ± 11.3 pg/ml); the median serum VEGF level was also higher in BD patients (239.7; range:53-991.3 pg/ml) than controls (189.4; range:53.6-357.9 pg/ml). But these differences were not statistically significant. Serum bFGF and VEGF levels were also not different statistically in ocular and non-ocular Behçet's patients. There was no statistically significant relationship between serum angiogenin, bFGF, and VEGF levels and the presence of active eye disease or anatomic location of uveitis. While there was a correlation of borderline significance in angiogenin levels between the patients with anterior uveitis and panuveitis (p = 0.053), we did not obtain any correlation between serum angiogenin, bFGF, and VEGF levels and the duration of BD. CONCLUSIONS: This study suggests that angiogenin may be associated with pathophysiology of BD, and highlights the need of further investigation of the role of angiogenin, bFGF, and VEGF serum levels in BD susceptibility and its clinical manifestations.

Accommodation Paralysis after Pheniramine Maleate Injection: A Case Report.

We present a case in which Gilbert syndrome was diagnosed following a neuro-ophthalmic complaint. Adverse effects of drugs as well as various systemic, neurological, and local ocular pathologies can cause accommodative insufficiency and loss of accommodation. A 29-year-old man was admitted to an ophthalmology department with blurred vision and diagnosed as suffering from acute accommodation paralysis. He had a history of being given a pheniramine maleate injection for pruritus 20 days previously. Symptoms began immediately following the injection. After systemic evaluation and laboratory tests, he was diagnosed as having Gilbert syndrome. His complaints and symptoms recovered in approximately a further 10 days. Metabolism of pheniramine maleate can be impaired in Gilbert syndrome and anticholinergic effects can cause accommodation paralysis.

Comparative study of laser flare photometry versus slit-lamp cell measurement in pediatric chronic non-infectious anterior uveitis.

PURPOSE: To evaluate the role of laser flare photometry (LFP) for monitoring the course of intraocular inflammation in children with chronic anterior uveitis. METHODS: Seventy-six eyes of 43 children with non-infectious chronic anterior uveitis were reviewed retrospectively. RESULTS: The median follow-up was 48.6 ± 23.1 months. Patients on immunosuppressive treatment at last follow-up, showed significantly higher flare values than patients who discontinued treatment (20.47 ± 15.49 vs. 6.33 ± 4.87 p < 0.001). The higher LFP values were correlated with the duration of immunosuppressive treatment, total duration of topical corticosteroid use and the risk for development of ocular complications at all follow-ups (all p < 0.001). No significant correlation was found between the AC cell grades and the duration of immunosuppressive treatment, topical corticosteroid use and the prevalence of complications. CONCLUSION: LFP measurements have a predictive value of monitoring the course of uveitis and the occurrence of ocular complications, and it should be considered as a primary modality to monitor intraocular inflammation in children with chronic anterior uveitis.

Pediatric Uveitis in Turkey: The National Registry Report II.

PURPOSE: To report demographic and clinical profiles of children with uveitis in theTurkishpopulation. METHODS: The data of the pediatric uveitis cases in the nation wide uveitis database were analyzed. RESULTS: The study included 697 eyes of 442 patients with a meanage of 10.8 ± 3.8 years. There were 333 patients (75.3%) with non-infectious uveitis and 69 patients (15.6%) with infectious uveitis. Pars planitis (20.1%) was leading clinical form followed by idiopathic cases with uveitis other than pars planitis (18.8%), juvenile idiopathic arthritis(JIA) related uveitis (12.4%), Behçet uveitis (9.3%) and toxoplasma retinochoroiditis (7.9%). Ocular involvement was unilateral in 187 patients (42.3%) and bilateral in 255 patients (57.7%). The most common anatomiclocation of uveitis was anterior uveitis (39.1%), followed by intermediate uveitis (29.4%), panuveitis (16.1%) and posterior uveitis (15.4%). CONCLUSION: The most common systemic association was JIA in the younger children and Behçet disease in the older children.

Serum vitronectin levels in patients with Behçet's disease.

BACKGROUND/AIMS: To determine serum vitronectin levels in Behçet patients with and without ocular involvement, and to evaluate the relationship between vitronectin concentrations and clinical manifestations of Behçet's disease (BD). METHODS: Sixty-five patients with BD and 21 control subjects were included. All patients were queried for the clinical manifestations of BD. Serum vitronectin concentrations were determined by using in vitro enzyme immunoassay kits. RESULTS: Serum vitronectin levels between the patients and the control subjects were not different. There was no statistically significant difference between vitronectin levels in Behçet patients with and without ocular involvement. No correlation was found between vitronectin concentrations and clinical manifestations. CONCLUSION: This is the first study evaluating vitronectin levels in Behçet patients. Further studies involving larger numbers of subjects would be useful to improve our understanding of the functions of vitronectin in BD.

Choroidal tuberculoma in a patient with ocular Behçet disease.

Behçet disease is a chronic relapsing inflammatory disease affecting many different organs. Ocular involvement is quite common in the course of Behçet disease and is frequently manifested by bilateral panuveitis and retinal vasculitis. Medications such as corticosteroids and immunosuppressive agents are used to reduce inflammation in patients with posterior or panuveitis. Chronic immunosuppression is a risk factor for systemic infections. We report a case of choroidal tuberculoma associated with tuberculosis in a patient with ocular Behçet disease. A 25-year-old female with known ocular Behçet disease contracted tuberculosis 3 months earlier. She had been receiving methotrexate and oral steroids. Funduscopy of the left eye revealed a choroidal tuberculoma located superonasally to the optic disc. Fluorescein angiography showed a central area of hypofluorescence surrounded by a hyperfluorescent zone. Since she was already receiving antituberculosis treatment combined with oral steroids, the same treatment was continued. Diagnosis of the other diseases that may cause uveitis in patients with Behçet disease should not be missed. This is especially important since immunosuppressive drugs, that cause an increased incidence of systemic infections, are the common treatment of choice for patients with Behçet disease.

Familial Mediterranean fever associated frosted branch angiitis, retinal vasculitis and vascular occlusion.

OBJECTIVES: To analyse the entity of retinal vasculitis, including frosted branch angiitis (FBA), or retina vascular occlusion in patients with familial Mediterranean fever (FMF). METHODS: Retrospective collaborative case series using invitation by email to uveitis specialists around the Mediterranean basin. This series was combined with a literature review. Exclusion criteria included infectious diseases, Behçet's disease or other autoimmune diseases. RESULTS: A total of 16 patients (21 eyes) had FMF and retinal vasculitis (FBA 11 patients, mild retinal vasculitis 5 patients). The mean age at onset of vasculitis was 29.5 ± 13.4 (range 9-62) with a female to male ratio of 9 to 7. In 19 eyes treated with various forms of corticosteroid and/or immunosuppression, the mean initial spectacle-corrected visual acuity improved from 6/194 to 6/10.5 at the last mean follow-up of 29.0 ± 34.9 months (p < 0.001). The most common FEVR mutations were M680I and M694V. In addition, retinal vascular occlusions included one case of central retinal artery occlusion and one case of branch retinal artery occlusion. CONCLUSION: FBA and milder forms of retinal vasculitis are associated with FMF. Therapy involves an increase in colchicine dosage in early cases, a long period of oral corticosteroid, intravitreal dexamethasone implant or periocular corticosteroid in select cases, and combination therapy with systemic immunosuppression in severe cases. FMF needs to be included in the differential diagnosis of retinal vasculitis.

COVID-19 and the Use of Immunomodulatory Agents in Ophthalmology

Immunomodulatory agents are often used in the systemic treatment of non-infectious uveitis. These drugs consist of corticosteroids, conventional immunosuppressives, and biological agents. As it is known that they suppress the immune system, the most important concern associated with immunomodulatory therapy (IMT) is the increased risk of infection. The World Health Organization declared COVID-19 a pandemic on 11 March 2020. Although severe acute respiratory distress syndrome secondary to SARS-CoV-2 infection may develop in all people, patients who receive IMT may be at higher risk in terms of both the transmission of the infection and more severe disease course. Therefore, guidelines on the management of patients receiving IMT due to uveitis during the pandemic are needed. In this review, we examined the immunomodulatory drugs used in the treatment of uveitis in terms of infectious complications and the data of patients who received IMT during the COVID-19 pandemic and discussed recommendations for the use of these drugs. According to the latest information, patients who receive IMT may continue their treatment as long as there are no disruptions in regular complete blood count (especially white blood cell count >4,000/µL) and liver and kidney function tests. Patients diagnosed with COVID-19 should be managed with a multidisciplinary approach.

Comparison of Sociodemographic Features Between Behçet Uveitis and Other Non-infectious Uveitis

Objectives: To analyze and compare sociodemographic features between Behçet uveitis and other non-infectious uveitis. Materials and Methods: The data of adults with non-infectious uveitis in the nationwide uveitis database were analyzed and the sociodemographic features of patients with and without Behçet disease were compared. Results: This study included data of 4,978 eyes of 3,363 patients from 33 centers. The mean age at presentation was 38.7±13.3 (17-87) years. The mean age was 34.3±10.5 years in the Behçet uveitis group and 41.1±14.0 years in the other non-infectious uveitis group (p<0.001). Male predominance was seen in the Behçet uveitis group (67.7% vs. 32.3%) while female patients were more common in the other non-infectious uveitis group (54.4% vs. 45.6%, p<0.001). Regarding education level, the proportion of patients with low education was higher in the Behçet uveitis group than the other non-infectious uveitis group (49.6% vs. 43.4% in males, p=0.004; 61.5% vs. 59.2% in females, p=0.021). Having a low-income job or being currently unemployed, indicators of poor income, were more frequent in the Behçet uveitis group than in the other non-infectious uveitis group (32.0% vs. 22.8%, p<0.001). In the comparison of places of residence, the proportion of patients who lived in cities with low gross national product was 37.0% in the Behçet uveitis group and 31.1% in the other non-infectious uveitis group (p<0.001). Conclusion: Patients with Behçet disease had lower education level and socioeconomic status than patients with other non-infectious uveitis entities.

The Clinical Characteristics of Pediatric Non-Infectious Uveitis in Two Tertiary Referral Centers in Turkey.

Purpose: To report the manifestations, patterns of disease, treatment strategies and outcomes in pediatric patients with noninfectious uveitis.Methods: Demographic information of 76 cases was recorded. Symptoms, anatomic location, laterality, visual acuity (VA), intraocular pressure, associated systemic diseases, therapeutic strategies, side effects, complications were reviewed.Results: Thirty-one patients were diagnosed as uveitis on routine surveillance because of underlying systemic disease. The most common anatomic location was intermediate uveitis (34.2%). Juvenile idiopathic arthritis (JIA) was the most common underlying systemic disease (25%). Glaucoma was the most common complication (7.7%). The patients with refractory uveitis received adalimumab (26.5%), infliximab (4.6%) and tocilizumab (3.1%). The mean first-year VA was between 20/32 and 20/20 in 116/140 eyes.Conclusion: Most pediatric noninfectious uveitis cases have bilateral intermediate uveitis. JIA was the most common systemic association. The first-year VA was good in most eyes which may be due to early use of corticosteroid-sparing agents.

An Algorithm for the Diagnosis of Behçet Disease Uveitis in Adults.

Purpose: To develop an algorithm for the diagnosis of Behçet's disease (BD) uveitis based on ocular findings.Methods: Following an initial survey among uveitis experts, we collected multi-center retrospective data on 211 patients with BD uveitis and 207 patients with other uveitides, and identified ocular findings with a high diagnostic odds ratio (DOR). Subsequently, we collected multi-center prospective data on 127 patients with BD uveitis and 322 controls and developed a diagnostic algorithm using Classification and Regression Tree (CART) analysis and expert opinion.Results: We identified 10 items with DOR >5. The items that provided the highest accuracy in CART analysis included superficial retinal infiltrate, signs of occlusive retinal vasculitis, and diffuse retinal capillary leakage as well as the absence of granulomatous anterior uveitis or choroiditis in patients with vitritis.Conclusion: This study provides a diagnostic tree for BD uveitis that needs to be validated in future studies.

Quantitative Evaluation of the Retinal Vascular Parameters With OCTA in Patients With Behçet Disease Without Ocular Involvement.

BACKGROUND AND OBJECTIVE: To evaluate the optical coherence tomography angiography (OCTA) features of patients with Behçet disease (BD) without ocular involvement. PATIENTS AND METHODS: Twenty-three patients with BD without ocular involvement and 29 healthy age/sex-matched control subjects were involved. The authors measured foveal avascular zone (FAZ) area, vessel density in the parafoveal region, and flow area (fovea-centered 3-mm radius area) in the superficial and deep capillary plexuses evaluated by OCTA. RESULTS: FAZ area was significantly larger in eyes with BD in both the superficial and deep capillary plexuses (0.331 vs. 0.240 mm2 [P = .004] and 0.352 vs. 0.257 mm2 [P = .003], respectively). Although mean capillary vessel density in parafoveal region and mean flow area were lower in eyes with BD for both superficial and deep capillary plexuses, these findings were not statistically significant. CONCLUSION: Microvascular changes in macular region can be identified in patients with BD without ocular manifestation. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:31-34.].

Soluble endothelial protein C receptor levels in Behçet patients with and without ocular involvement.

BACKGROUND: The protein C system is an important natural anticoagulant mechanism. Endothelial cell-activated protein C receptor (EPCR), which was discovered at the surface of endothelial cells, binds protein C and enhances its activation. The soluble form of EPCR (sEPCR) has been detected in plasma. Behçet's disease is a chronic inflammatory disorder affecting multiple organs. Arterial and venous thrombosis is a common clinical manifestation of Behçet's disease and the pathogenic mechanism of thrombotic tendency in the disease is not well known. The aim of this study is to determine sEPCR concentrations in Behçet patients with and without ocular involvement as well as to investigate the association between sEPCR levels and clinical manifestations of Behçet's disease. METHODS: Sixty patients with Behçet's disease and 67 healthy control subjects were included in this study. A complete ophthalmic examination was performed by ophthalmologists with an interest in Behçet's disease. Sixty patients with Behçet's disease were divided into two groups. Group 1 consisted of 30 patients with ocular involvement and Group 2 consisted of 30 patients without ocular involvement. Soluble EPCR levels were determined in plasma by using sEPCR Asserachrom enzyme-linked immunosorbent assay (ELISA) kits according to the manufacturer's instructions. Differences of the mean sEPCR levels between groups were evaluated using Mann-Whitney U-test. Pearson's correlation analysis was used for evaluating the correlation between sEPCR levels and age, gender, duration of the disease as well as different clinical manifestations of Behçet's disease. RESULTS: Age and gender ratio were not different between patients and controls. Plasma sEPCR concentrations were significantly higher in patients with Behçet's disease than those in controls (p<0.05). There was no statistically significant difference in serum sEPCR levels between the patients with versus the ones without ocular involvement. There were no statistically significant correlations between sEPCR levels and age, gender, duration of the disease or clinical manifestations. CONCLUSIONS: Our data suggests a possible role of soluble EPCR in the pathogenesis of Behçet's disease. Further studies by possible mutations and polymorphisms in EPCR gene in patients with Behçet's disease would be useful to bring to light the pathogenic mechanism of ocular and systemic vascular complications of the disease.

Repair of anterior staphyloma with dehydrated dura mater patch graft.

A case of postoperative large anterior staphyloma of the sclera was treated with a dehydrated cadaveric dura mater patch graft. Structural integrity of the globe and a good cosmetic result were obtained after the surgery. During the follow-up of 2 years, no recurrence of staphyloma developed.

Mycophenolate mofetil in the treatment of ocular inflammation in ANCA-associated vasculitis.

AIM: The aim of this study was to describe the use of mycophenolate mofetil (MMF) in the treatment of patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis with ocular involvement. METHODS: A retrospective review was performed. Ocular and systemic manifestations, history of previous immunosuppressive drug therapy, concurrent therapy with MMF, response to treatment, side effects related to the use of MMF, and follow-up period were recorded. RESULTS: Nine (9) eyes of 5 patients were evaluated. Ocular involvement included scleritis, choroidal and orbital granuloma, multifocal choroiditis, intermediate uveitis, and lacrimal gland involvement. Mycophenolate was started at 2 g daily. Mean follow-up after the initiation of MMF was 36 months. Mean prednisolone dose at onset of treatment with MMF was 27 mg daily and was reduced to 7 mg daily as disease control was achieved. Visual acuity was maintained or improved in all eyes, apart from 1 eye, which developed cataract formation. One (1) patient required a reduction in the dose of mycophenolate owing to diarrhea. CONCLUSIONS: Our study suggests that mycophenolate mofetil may be a safe, effective therapeutic modality for ocular inflammation associated with ANCA-associated vasculitis.

Serum haptoglobin levels in ocular Behçet disease and acute phase proteins in the course of Behçet disease.

PURPOSE: Changes in concentrations of acute phase proteins in the serum of patients might be significant in the pathogenesis of Behçet disease. This report investigates the association between ocular disease activity and serum haptoglobin levels in patients with Behçet disease, and summarizes the current understanding of the correlation between acute phase proteins and Behçet disease based on both personal studies and data from the literature. METHODS: Thirty patients with Behçet disease with ocular involvement and 15 healthy subjects were included in the study. Of the 30 patients, 14 had acute uveitis and 16 had inactive ocular involvement at the time of enrollment. RESULTS: There was a significant difference in haptoglobin levels between the patients with active ocular disease and controls (p=0.0005). There was also a significant difference in haptoglobin levels between the patients with inactive ocular disease and control subjects (p<0.0001). However, no significant difference was observed among patients with active versus inactive uveitis with regard to serum haptoglobin levels. CONCLUSIONS: Higher serum haptoglobin levels in patients with Behçet disease compared to control subjects were obtained. However, elevated serum haptoglobin levels do not seem to be a risk factor for uveitis activity. Behçet disease is generally diagnosed by physical examinations and no laboratory marker has been widely accepted for follow-up of disease activity.