Epidemiological features and visual prognosis of Behcet's disease

Purpose: Retrospective evaluation of epidemiological features and visual prognosis of patients with Behcet's disease (BD) who visited the University of Tokyo Hospital between 1974 and 1993. Observations: During the survey period, more than 100 new patients with BD visited the uveitis clinic in each 5-year period. The number of new patients decreased in the most recent 5-year period from 1989 to 1993, Although ED has always been more prevalent in men, the percentage of women has increased to 24.7% (19/77) in the most recent 5-year survey period. The percentage of patients who initially manifested ocular symptoms in their third or fourth decade was more than 70%, The proportion of the incomplete type of ED gradually had increased to 62.3% (48/77) by 1993. Among the extraocular major symptoms, oral aphtha and skin lesions have been frequent and genital ulcer has become less frequent in the last 20 years. The patients whose visual acuity was better than 0.4 at the first visit in the 1984-1993 period had a significantly better visual prognosis than the patients in the previous 10-year period. The main drug therapy consisted of colchicine and cyclophosphamide in the earlier 10-year period, and of colchicine and ciclosporin in the later 10-year period. Conclusions: Behcet's disease is still one of the most frequently encountered types of endogenous uveitis, There have been some changes in the epidemiological features of the patients with BD over the past 20 years. The introduction of ciclosporin in 1985 is probably responsible for the improvement of the visual prognosis in ED patients. Jpn J Ophthalmol 1999;43:312-317. (C) 1999 Japanese Ophthalmological Society.