Demyelination of retinal myelinated nerve fibers in Behcet's disease

A 39 year-old Behcet's patient had demyelination of retinal myelinated nerv e fibers after recurrent papillitis and vitritis. Oral Prednisolone, cyclos porine, and later periocular corticosteroids and oral colchicine were used but demyelination continued over a 5 year-period. A pseudobulbar palsy with urinary incontinence and pyramidal tract signs developed and azathioprine and corticosteroids were used. Demyelination of retinal nerve fibers stoppe d and while treatment was underway, the central nervous system (CNS) signs were stable. While the ocular pathology of Behcet's can mirror the CNS sign s, indeed optic nerve ischemic demyelination may signal the potential for C NS involvement; azathioprine with prednisone may be more effective in the l ong-term for optic nerve and CNS involvement than cyclosporine with prednis one.