White cataract in a young patient with Behcet’s disease
DOI:
https://doi.org/10.70313/2718.7446.v15.n04.200Keywords:
Behcet’s uveítis, secondary cataract, white cataract, phacoemulsification, uveitisAbstract
Objective: To describe an atypical case of cataract and Behcet’s disease.
Case report: A 20-year-old female consulted for chronic decrease of vision in her right eye (OD). She had a history of chronic use of topical corticosteroids for uveitis in her OD since childhood. Biomicroscopy showed a white cataract in the OD, without anterior chamber reaction in both eyes. The left eye was completely normal. B-mode ultrasound showed retina and vitreous with no particularities. Laboratory test were requested in the context of a patient with a history of uveitis, including HLA-B51, which was reported as compatible for Behcet’s disease with genetic polimorphisms, and other causes were ruled out by the test. Consultation with rheumatology was indicated for control and initiation of systemic treatment. Cataract extraction was performed by phacoemulsification with intraocular lens implantation. No postoperative complications occurred and the patient recovered her visual capacity, currently stable after six months of follow-up.
Conclusion: We describe the atypical case of a patient with a rare uveitis in our environment, who presented a secondary cataract, from which Behcet’s disease was diagnosed. The cataract was successfully resolved surgically and the patient is under treatment and general clinical follow-up.
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References
International Study Group for Behçet’s Disease. Criteria for diagnosis of Behçet’s disease. Lancet 1990; 335: 1078-1080.
Davatchi F, Chams-Davatchi C, Shams H et al. Behcet’s disease: epidemiology, clinical manifestations, and diagnosis. Expert Rev Clin Immunol 2017; 13: 57-65.
Citirik M, Berker N, Songur MS et al. Ocular findings in chilhood-onset Behçet disease. J AAPOS 2009; 13: 391-395.
Zhang Y, Zhu X, He W et al. Efficacy of cataract surgery in patients with uveítis: a STROBE-compliant article. Medicine (Baltimore) 2017; 96: e7353.
Sota J, Cantarini L, Vitale A et al. Long-term outcomes of Behçet’s syndrome-related uveitis: a monocentric Italian experience. Mediators Inflamm 2020; 2020: 6872402.
Alfawaz A, Alrashidi S, Kalantan H et al. Cataract surgery under systemic infliximab therapy in patients with refractory uveitis associated with Behçet disease. Ann Saudi Med 2014; 34: 328-333.
Hu K, Lei B, Kijlstra A et al. Male sex, erythema nodosum, and electroretinography as predictors of visual prognosis after cataract surgery in patients with Behçet disease. J Cataract Refract Surg 2012; 38: 1382-1388.
James ER. The etiology of steroid cataract. J Ocul Pharmacol Ther 2007; 23: 403-420.
Kramer M, Tomkins-Netzer O. Cataract risk and topical corticosteroids among children with juvenile idiopathic arthritis-related uveitis. Ophthalmology 2020; 127 (4 Suppl): S19-S20.
Foster CS, Rashid S. Management of coincident cataract and uveítis. Curr Opin Ophthalmol 2003; 14: 1-6.
Mehta S, Linton MM, Kempen JH. Outcomes of cataract surgery in patients with uveitis: a systematic review and meta-analysis. Am J Ophthalmol 2014; 158: 676-692.e7.
Reddy AK, Patnaik JL, Miller DC et al. Risk factors associated with persistent anterior uveitis after cataract surgery. Am J Ophthalmol 2019; 206: 82-86.
Hatemi G, Christensen R, Bang D et al. 2018 update of the EULAR recommendations for the management of Behçet’s syndrome. Ann Rheum Dis 2018; 77: 808-818.
Roberti G, Oddone F, Agnifili L et al. Steroid-induced glaucoma: epidemiology, pathophysiology, and clinical management. Surv Ophthalmol 2020; 65: 458-472.
Ucar D, Mergen B, Gonen B et al. Investigation of clinical profile of Behçet’s syndrome-related versus idiopathic branch retinal vein occlusion. Indian J Ophthalmol 2020; 68: 1876-1880.
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