Irreversible visual loss and posterior uveitis as the initial manifestation of Behcet’s Disease

Abstract

We report a rare case of rapid onset, severe visual loss in a young male patient with Behcet’s disease who had ocular disease as an initial manifestation. Vision was perception of light with inaccurate projection in both eyes. Anterior segment showed no inflammation. Fundus examination revealed vitritis, total optic atrophy, branch retinal vein occlusion and cellophane maculopathy. Visual evoked potential showed delayed P 100 responses in the left eye suggestive of left anterior visual pathway conduction defect. Systemic examination showed no active symptom complex. There was no response to oral corticosteroids or immunosuppressive drugs. Though rare in the Indian population, Behcet’s disease can be severe, progress rapidly and is less responsive to conventional treatment as in our patient. This case is presented for its rarity, as ocular features were the initial and only manifestation. Despite immediate therapy with corticosteroids and immunosuppressives, continued inflammation resulted in visual loss.