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- W4238941463 abstract "We thank Dr Liu for the interest in our article and will respond to the questions raised (1). First, Dr Liu pointed out that a single photograph of the fluorescein angiogram does not offer enough evidence for a diagnosis of central retinal artery occlusion (CRAO). We have already extensively discussed this with the reviewers and editor of the journal before our article was accepted. When we did this, we carefully reviewed the fluorescein angiogram and found in the early phase of the study that there was good choroidal filling (Fig. 1). In the Photo Essay, Figure 2A shows a later stage of the angiogram when filling of the choroid was complete, yet there was no perfusion of the retinal vessels. Furthermore, the appearance of the vascular occlusion in Figure 2A is actually more suggestive of an occlusive vasculitis than a CRAO caused by emboli, adding further support for the diagnosis of Behçet disease (BD). Second, regarding the issue of diagnostic criteria for BD, our patient admitted to recurrent oral ulcers more than 5 times per year. Finally, we agree that CRAO and recurrent papillitis are not listed as minor features in the diagnostic criteria of BD (2), but “vasculitis” and “central nervous system symptoms” are included. If we accept that the vascular occlusion observed in each eye of our patient was caused by vasculitis and that the optic nerve is part of the central nervous system, then we have 2 minor features of BD. While recurrent oral ulcers are a major feature, it is noteworthy that diagnostic criteria for BD vary and have been revised many times. The International Study Group for BD proposed that the diagnosis be considered when recurrent oral ulcers plus 2 other features are present, in the absence of other clinical explanations (3). In our patient, we performed a wide range of ancillary tests to exclude other disorders, which can cause an obliterative vasculitis.FIG. 1: Early phase of fluorescein angiogram demonstrates choroidal filling.Most importantly, we wish to remind clinicians that CRAO and recurrent papillitis can be caused by a vasculitis, such as BD. Prompt treatment can be helpful to prevent further loss of visual function." @default.
- W4238941463 created "2022-05-12" @default.
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- W4238941463 date "2012-03-01" @default.
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- W4238941463 title "Central Retinal Artery Occlusion and Recurrent Papillitis in a Patient With Incomplete Behçet Disease" @default.
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- W4238941463 doi "https://doi.org/10.1097/wno.0b013e318240beb5" @default.
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