Figen Batioglu, MD (Ankara, Turkey), Emin Özmert, Prof (Ankara, Turkey), Neslihan Astam, MD (Ankara, Turkey)

PURPOSE:

Recurrent uveitis attacks despite corticosteroid, immunosuppressive and immunomodulating treatments may cause anterior and posterior segment complications in Behçet’s disease. Vitreoretinal surgery may have beneficial effect on anatomic, visual prognosis, and the course of the disease in patients with severe ocular complications.

METHODS:

This retrospective study included 34 eyes of 30 Behçet patients who had undergone vitreoretinal surgery. Those patients had vitreoretinal complications and persistent uveitis despite maximum medical therapy. Surgical outcomes were measured by improvement in logMAR visual acuity, acute relaps rates, postoperative medication and complications.

RESULTS:

Indications of vitreoretinal surgery were vitreous opacities and/or cataract (16 eyes), vitreous hemorrhage (5 eyes), cystoid macular edema (2 eyes), macular pucker (1 eye), retinal detachment (6 eyes), PVR (1 eye), hypotony (2 eyes) and vitreomacular traction (1 eye). After surgery, for almost all patients logMAR visual acuity significantly improved (p<0.001) and uveitis attacks significantly decreased (p<0.01). The results were unfavorable in 5 eyes with preoperative retinal detachment (3 eyes), PVR (1 eye), and severe hypotony (1 eye). During the follow-up, neovascular glaucoma and hypotony were observed in two eyes with
PVR and hypotony preoperatively. Phthisis was not observed in any eye during the postoperative period.

CONCLUSION:

Vitreoretinal surgery may be both safe and effective for the management of vitreoretinal complications, for the control and reduce the frequency of ocular attacks, and for the stabilization of visual acuity in Behçet’s disease. Phthisis, neovascular glaucoma and severe hypotony are very rare related with preoperative status.