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Ocular Immunology and Inflammation Volume 29, 2021 - Issue 6
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Original Article

An Algorithm for the Diagnosis of Behçet Disease Uveitis in Adults

Ilknur Tugal-Tutkuna Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, TurkeyCorrespondence[email protected] [email protected]
ORCID Iconhttps://orcid.org/0000-0002-4020-453X
, MDORCID Icon,
Sumru Onalb Department of Ophthalmology, School of Medicine, Koc University, Istanbul, Turkey
, MD, FEB.Ophth,
Miles Stanfordc Medical Eye Unit, St Thomas’ Hospital, London, UK
, MD,
Mehmet Akmand Department of Family Medicine, School of Medicine, Marmara University, Istanbul, Turkey
, M.D, MPH,
Jos W.R. Twiske Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
, Ph.D,
Maarten Boersf Department of Epidemiology and Biostatistics, Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, The Netherlands
, Ph.D,
Merih Oraya Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, TurkeyORCID Iconhttps://orcid.org/0000-0003-2830-6311
, MDORCID Icon,
P. Özdalg Department of Ophthalmology, University of Health Sciences, Ulucanlar Eye Education and Research Hospital, Ankara, Turkey
, MD,
Sibel Kadayifcilarh Department of Ophthalmology, Hacettepe University Faculty of Medicine, Ankara, Turkey
, MD,
Radgonde Ameri Department of Ophthalmology, Hadassah Medical Center, Jerusalem, Israel
, MD,
Sivakumar R. Rathinamj Department of Ophthalmology, Aravind Eye Care System, Madurai, India
, MD,
Rajesh Vedhanayakij Department of Ophthalmology, Aravind Eye Care System, Madurai, India
, MD,
Moncef Khairallahk Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia
, MD,
Yonca Akoval Department of Ophthalmology, Bayindir Hospital, Ankara, Turkey
, MD,
F. Yalcindagm Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, TurkeyORCID Iconhttps://orcid.org/0000-0002-8963-5146
ORCID Icon,
Esra Kardesn Eye Clinic, University of Health Science, Ümraniye Training and Research Hospital, Istanbul, Turkey
, MD,
Berna Basariro Eye Clinic, University of Health Science, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
, MD,
Çigdem Altano Eye Clinic, University of Health Science, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
, MD,
Yilmaz Özyazganp Department of Ophthalmology, Istanbul Cerrahpasa University Faculty of Medicine, Istanbul, Turkey
, MD &
Ahmet Gülq Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
, MD show all
Pages 1154-1163 | Received 15 Sep 2019, Accepted 25 Feb 2020, Published online: 14 Apr 2020
 
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ABSTRACT

Purpose: To develop an algorithm for the diagnosis of Behçet’s disease (BD) uveitis based on ocular findings.

Methods: Following an initial survey among uveitis experts, we collected multi-center retrospective data on 211 patients with BD uveitis and 207 patients with other uveitides, and identified ocular findings with a high diagnostic odds ratio (DOR). Subsequently, we collected multi-center prospective data on 127 patients with BD uveitis and 322 controls and developed a diagnostic algorithm using Classification and Regression Tree (CART) analysis and expert opinion.

Results: We identified 10 items with DOR >5. The items that provided the highest accuracy in CART analysis included superficial retinal infiltrate, signs of occlusive retinal vasculitis, and diffuse retinal capillary leakage as well as the absence of granulomatous anterior uveitis or choroiditis in patients with vitritis.

Conclusion: This study provides a diagnostic tree for BD uveitis that needs to be validated in future studies.

Acknowledgments

The authors thank the uveitis experts who answered the questionnaire on diagnostic features of BD uveitis: Yonca Akova (Turkey), Sibel Kadayifcilar (Turkey), Gungor Sobaci (Turkey), Merih Soylu (Turkey), Sumru Onal (Turkey), Pinar Ozdal (Turkey), Yilmaz Ozyazgan (Turkey), Nilufer Yalcindag (Turkey), Nida Sen (USA), Narsing Rao (USA), Emmett Cunningham (USA), Andrew Dick (UK), Miles Stanford (UK), Arnd Heiligenhaus (Germany), Uwe Pleyer (Germany), Luca Cimino (Italy), Pia Allegri (Italy), Soon Phaik Chee (Singapore), Radgonde Amer (Israel), Khalid Tabbara (Saudi Arabia), and Moncef Khairallah (Tunisia).

Disclosures

The following authors disclose financial support outside the submitted work:

Ilknur Tugal-Tutkun: Consultant, AbbVie; Lecturer, Allergan

Miles Stanford: Lecturer, Allergan and AbbVie

Ahmet Gül: Consultant, AbbVie, Amgen, and MSD

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Supplementary Material

Supplemental data for this article can be accessed on the publisher’s website.

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