Quadruple Thera py of Behcet's Disease

Behcet's disease is a multisystematic inflammatory disorder affecting eyes. Visual loss is the most serious effect of Behcet's disease with posterior segment involvement.Because of the disorder's devastating visual consequences, its treatment has received considerable attention.Since the treatment of Behcet's disease has often been unsatisfactory, many different types of treatment have been attempted. We retrospectively reviewed the charts of 28 patients with severe ocular Behcet's disease involving posterior segment.The patients with posterior segment involvement were initially treated with triple regimen (corticosteroid, colchicines, and azathioprine).If intraocular inflammation does not resolve or the inflammatory process recurs, combination with low doses of cyclosporine should be considered (quadruple therapy).Over the course of therapy, visual acuity improved in 25 of 51 eyes (49.01%), remained stable in 14 of 51 eyes (27.45%), and declined in 12 of 51 eyes (23.52%).It improved or maintained the visual acuity in 39 of 51 eyes.There were no serious side effects attributable to triple or quadruple therapy that required withdrawal. The use of corticosteroids, colchicines, azathioprine, and cyclosporine may improve therapeutic efficacy and limit the adverse drug effects, and this combination method appears to be an effective treatment for the ocular complications of Behcet's disease.

The Amniotic Membrane Transplantatin and Laser Photocoagulation after Lamella Keratectomy of Primary Corneal Lipid Degeneration

Opacification of the cornea due to the deposition of lipids may be primary without evidence of previous corneal vascularization, or secondary to either preexisting corneal disease or systemic disturbances of lipid metabolism. If the deterioration of vision continues, penetrating keratoplasty may be needed. We evaluated a 19 year-old female patient referred to our department due to progressive corneal opacity in the left eye. She did not have significant past or family histories of corneal diseases. Ocular examinations revealed the whitish corneal deposits with deep stromal vascularization in her left eye. For confirmation of the diagnosis, lamellar keratectomy with amniotic membrane transplantation was performed and deep stromal vessels were photocoagulated using an argon laser. Histologic findings were compatible with lipid degeneration. The corneal opacities reduced markedly and did not show any evidence of recurrence during the follow up period of six months. Therefore, we report this case with the review of the literature.