Purpose We aimed to describe the demographic and clinical features, ocular man ifestations, complications, visual prognosis, and treatment in a large populatio n of Turkish patients with Behcet uveitis. We also aimed ...Purpose We aimed to describe the demographic and clinical features, ocular man ifestations, complications, visual prognosis, and treatment in a large populatio n of Turkish patients with Behcet uveitis. We also aimed to compare visual progn osis between male and female sex and between patients who presented before and a fter 1990. Design Observational case series. Methods A retrospective study of 88 0 consecutive patients (1,567 eyes) with Behcet uveitis seen at the Uveitis Serv ice, Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul Univers ity, from 1980 to 1998. All patients met the classifi cation criteria of the Int ernational Study Group for Behcets Disease. Information on the patients sex, age at onset of uveitis, ocular features, ocular complications, visual acuity, and systemic treatment was collected. Results Five hundred ninetynine patients ( 68%)weremale and 281 (32%)were female. The mean age at onset of uveitiswas 28. 5 years inmale and 30 years in female patients. Ocular involvement was bilateral in 78.1%and unilateral in 21.9%of the patients. Panuveitiswas the most common form in both sexes. Fundus lesions as well as sightthreatening complications we re more common in males. At the beginning of the follow up, potential visual ac uity was 0.1 or less in 30.9%of eyes in males and 24.2%of eyes in females. Kap lan Meier survival analysis estimated the risks of losing useful vision (>0.1) at 5 and 10 years for males and females as 21%vs 10%and 30%vs 17%, respectiv ely. Male patients who presented in the 1990s had a significantly lower risk of losing vision compared with male patients who presented in the 1980s. Conclusion Behcet uveitis starts frequently around the end of the third decade and has a m ale predominance. The disease is more severe and the risk of losing useful visio n is higher in males than in females. However, this risk has been significantly reduced in the 1990s.展开更多
Thalidomide,an immunomodulatory drug,is widely recommended for the treatment of recurrent aphthous stomatitis(RAS).This review aimed to assess the reliability of thalidomide for managing RAS,oro-genital ulcers associa...Thalidomide,an immunomodulatory drug,is widely recommended for the treatment of recurrent aphthous stomatitis(RAS).This review aimed to assess the reliability of thalidomide for managing RAS,oro-genital ulcers associated with Behçet’s disease(BD),and RAS in individuals with HIV infection.A systematic review was conducted following PICOS(Patient,Intervention,Control,Outcome,Study design)principles.Given the heterogeneity across studies,a qualitative analysis was performed in place of a meta-analysis.Eight randomized controlled trials(RCTs)were deemed eligible for inclusion.In three RCTs focused on RAS,a dosage of thalidomide at 100 mg/d demonstrated efficacy,while a lower dose of 25 mg/d helped prolong the recurrence interval of RAS.For oro-genital ulcers of BD,two RCTs indicated that both 300 mg/d for 24 weeks and 200 mg/d for 28 d,preceded by an initial dose of 400 mg/d for 5 d,were effective.In three RCTs investigating RAS in HIV-infected patients,thalidomide at 200 mg/d for either 4 or 7 weeks,with an initial dose of 400 mg/d for the first week,proved effective.However,a regimen of 100 mg three times per week failed to prevent the recurrence of oral ulcers.Adverse reactions to thalidomide were generally tolerable within the dosage ranges used in these studies.Overall,thalidomide showed promising efficacy for treating RAS,oro-genital ulcers in BD,and RAS in HIV-infected individuals.However,the variability in trial designs,dosages,and treatment durations makes it challenging to recommend an optimal dose and course of therapy.Further high-quality RCTs are necessary to establish more definitive guidelines.展开更多
文摘Purpose We aimed to describe the demographic and clinical features, ocular man ifestations, complications, visual prognosis, and treatment in a large populatio n of Turkish patients with Behcet uveitis. We also aimed to compare visual progn osis between male and female sex and between patients who presented before and a fter 1990. Design Observational case series. Methods A retrospective study of 88 0 consecutive patients (1,567 eyes) with Behcet uveitis seen at the Uveitis Serv ice, Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul Univers ity, from 1980 to 1998. All patients met the classifi cation criteria of the Int ernational Study Group for Behcets Disease. Information on the patients sex, age at onset of uveitis, ocular features, ocular complications, visual acuity, and systemic treatment was collected. Results Five hundred ninetynine patients ( 68%)weremale and 281 (32%)were female. The mean age at onset of uveitiswas 28. 5 years inmale and 30 years in female patients. Ocular involvement was bilateral in 78.1%and unilateral in 21.9%of the patients. Panuveitiswas the most common form in both sexes. Fundus lesions as well as sightthreatening complications we re more common in males. At the beginning of the follow up, potential visual ac uity was 0.1 or less in 30.9%of eyes in males and 24.2%of eyes in females. Kap lan Meier survival analysis estimated the risks of losing useful vision (>0.1) at 5 and 10 years for males and females as 21%vs 10%and 30%vs 17%, respectiv ely. Male patients who presented in the 1990s had a significantly lower risk of losing vision compared with male patients who presented in the 1980s. Conclusion Behcet uveitis starts frequently around the end of the third decade and has a m ale predominance. The disease is more severe and the risk of losing useful visio n is higher in males than in females. However, this risk has been significantly reduced in the 1990s.
文摘Thalidomide,an immunomodulatory drug,is widely recommended for the treatment of recurrent aphthous stomatitis(RAS).This review aimed to assess the reliability of thalidomide for managing RAS,oro-genital ulcers associated with Behçet’s disease(BD),and RAS in individuals with HIV infection.A systematic review was conducted following PICOS(Patient,Intervention,Control,Outcome,Study design)principles.Given the heterogeneity across studies,a qualitative analysis was performed in place of a meta-analysis.Eight randomized controlled trials(RCTs)were deemed eligible for inclusion.In three RCTs focused on RAS,a dosage of thalidomide at 100 mg/d demonstrated efficacy,while a lower dose of 25 mg/d helped prolong the recurrence interval of RAS.For oro-genital ulcers of BD,two RCTs indicated that both 300 mg/d for 24 weeks and 200 mg/d for 28 d,preceded by an initial dose of 400 mg/d for 5 d,were effective.In three RCTs investigating RAS in HIV-infected patients,thalidomide at 200 mg/d for either 4 or 7 weeks,with an initial dose of 400 mg/d for the first week,proved effective.However,a regimen of 100 mg three times per week failed to prevent the recurrence of oral ulcers.Adverse reactions to thalidomide were generally tolerable within the dosage ranges used in these studies.Overall,thalidomide showed promising efficacy for treating RAS,oro-genital ulcers in BD,and RAS in HIV-infected individuals.However,the variability in trial designs,dosages,and treatment durations makes it challenging to recommend an optimal dose and course of therapy.Further high-quality RCTs are necessary to establish more definitive guidelines.
