Patients And Methods

Since 1999 we included 24 consecutive ABD patients with ocular involvement who provided informed consent in an IFNa treatment protocol. The mean follow-up since initiation of the treatment was 18 months (6-36 months). The mean age at the onset of the disease was 28 years (18-38 years), whereas the beginning of ocular symptoms 30 years (23-40 years). At the time of initiation of the treatment all 24 patients showed oral ulcerations, whereas some patients presented genital ulcerations (n=7), arthritis (n=9), skin lesions (n=16), or cerebral involvement (n=1). All patients underwent a complete ophthalmologic examination including visual acuity measurement, slitlamp examination of the anterior segment, and indirect ophthalmoscopy of the vitreous body and fundus. We detected iritis in 20 of the 24 patients, 21 had ocular vasculitis, and 12 patients had a neuropathy ofthe optic nerve.

Patients received IFNa-2a (6-9 Mio IU 3x/week) subcutaneously as long-term therapy. Treatment was initiated at relapse of the eye disease. Corticosteroids (prednisolone 100 mg/day/p.o.) were administered additionally, and were tapered within 2 weeks to a maintenance dose of 10 mg/day. IFNa-2a was lowered to 6 and then to 3 Mio IU 3x/week, provided a 4-month period without ocular inflammation. After a 6-month period without ocular inflammation corticosteroids were discontinued.

Figure 1. Hypopyon iritis
Figure 2. Retinal occlusive vasculitis, peripapillary located with retinal bleeding as first ocular symptoms
Figure 3. Acute retinal vasculitis of small vessels in the lower periphery, one week after the patient stopped IFNa-treatment on her own

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