Behcet's disease: treatment and visual prognosis

ABSTRACT

We carried out a controlled study to compare the effect of the immunosuppressant drug chlorambucil with that of corticosteroids on the ocular type of Behcet's disease. Of our 26 patients, 20 were male and 6 female; all except 9 had suffered from previous episodes and had received systemic steroid therapy at those times. Follow-up varied from 8 to 48 months [average 2 ' years]. Chlorambucil treatment was found to induce remission in 11 of the 13 patients in that group, in two of these for 4 years; this drug was thus found to be effective in about 85% of cases, considerably reducing the intensity of the ocular inflammation and often producing long periods of remission. Steroid treatment alone, on the other hand, was found to be initially effective in about 54% of cases, about half of the eyes in this group suffering repeated exacerbations under maintenance therapy. In the long term, however, visual acuity had decreased about equally in both groups, and the visual prognosis remains poor regardless of the type of therapy despite intensive treatment, loss of useful vision had occurred in 78.6% of all eyes that were followed for 3 to 4 years after initial diagnosis