Histopathology of Behçet’s uveitis

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Abstract

Purpose To report the histological findings in an eye with severe Behçet’s disease.

Methods A 17-year-old male had a longstanding history of chronic intraocular inflammation, which was treated with high dose steroids, immunosuppression and biological agents (anti-TNF therapy). Despite this aggressive treatment, he suffered persistent uveitis, and had also undergone cataract and pars plana vitrectomy with silicone oil tamponade. Eventually the patient underwent enucleation of his left eye, which had become blind and painful. The specimen was sent to the Pathology Dept. RLBUHT, for morphological examination.

Results Histological sections of the enucleated eye demonstrated extensive pathological changes. These included: chronic keratitis with associated neovascularisation; severe chronic granulomatous iridocyclitis with the development of anterior synechiae with angle closure, as well as extensive posterior cyclitic membrane formation with ciliary process destruction. The inflammation, which was characterised by dense lymphocytic and plasma cell infiltrates, extended posteriorly into the choroid, focally involving the retina. Chronic vasculitis resulted in a typical “onion-skinning” appearance of some blood vessels. There was optic disc cupping. Immunohistochemistry was performed to characterise the lymphocytic and plasma cell populations.

Conclusion This case is a rare example of end-stage Behçet’s disease in which the histopathological alterations will be demonstrated.

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