THE INFLUENCE OF THE DELAY IN AGGRESSIVE TREATMENT ON THE VISON AND ITS OUTCOME IN BEHCET’S DISEASE.


Abstract: Introduction: The natural course of eye lesions is well known, leading to sever loss of vision or blindness. The cumulative nature of eye lesions during successive attacks, leads to gradual loss of visual acuity (VA). The aim of this study was to evaluate the effect of the delay in aggressive treatment on the VA and its long-term outcome. Materials and Methods: All Behcet’s patients of the treatment registry (1009 at January 20, 2002) entered the study. They were divided in subgroups according to delay in the institution of an aggressive treatment: up to one year (G1), 1 to 2 years (G2), 2 to 3 years (G3), 3 to 4 years (G4), 4 to 5 years (G5), more than 5 years (G6). The mean VA was calculated at the entry and after the last evaluation. Results: 429 eyes were in G1 group; their mean VA at the entry was 4.5, it improved to 5.6 in mean treatment duration (TD) of 20.5 months, p<0.0001 (429 eyes, mVA 4.5/5.6, 20.5 m, p<0.0001). G2 results were 341 eyes, mVA 3.9/4.6, 16.8 m, p=0.0001. G3 results were 220 eyes, mVA 3.4/4, 18.1 m, p=0.012. G4 results were 116 eyes, mVA 3.4/4.3, 20.7 m, p=0.003. G5 results were 78 eyes, mVA 3.7/4.7, 22.1 m, p=0.009. G6 results were 173 eyes, mVA 3.5/4.1, 22.7 m, p=0.01. Conclusion: All patients had a treatment for their eye lesion as soon as it started by their physicians. However, their treatment was rarely adequate and enough aggressive. The delay in aggressive treatment leads to a decrease in mean VA As seen by the results in groups G1, G2, and G3. From there, the mean entry value didn’t decrease anymore. The delay in aggressive treatment didn’t impede the improvement course of the therapy.