[Comparative evaluation of the effectiveness of corticosteroids and cytostatics in treating retinal angiitis in Behcet's disease].

Posterior uveitis and retinal vasculitis (RV) are the main causes of severe loss of vision or blindness in patients with Behçet's disease (BD). Treatment of RV in BD is a difficult problem, because the agents are effective in posterior uveitis and ineffective in RV. We observed 26 RV BD patients (20 men and 6 women aged 18-46 years, mean age 30.8 +/- 6.5 years), who were treated with corticosteroids and cytostatic drugs. Corticosteroids were used by pulse therapy, orally, and locally (periocular injections) during the active period. The results of pulse-therapy or oral corticosteroids were better than of periocular injections (92.8, 90.9, and 45.5%, respectively, p < 0.009). The velocity of reduction of inflammation and the degree of visual acuity improvement were better in the patients who received steroid pulse-therapy (12.7 +/- 2.4 and 0.19 +/- 0.21 days, respectively) in comparison with those who received oral steroids (17.7 +/- 1.8 days, p < 0.000, and 0.08 +/- 0.07, p = 0.0121). A combination of cyclophosphamide (200 mg/week intravenously) with prednisolone (10-15 mg/day) and cyclosporin (3.5 mg/kg/day) with prednisolone (10-15 mg/day) were effective for long control of RV BD patients.