• Ehud Zamir, Bahram Bodaghi, Ilknur Tugal-Tutkun, Robert F See, Frederic Charlotte, Robert C Wang, Bertrand Wechsler, Phuc LeHoang, Irene Anteby, and Narsing A Rao.
• Doheny Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, USA.
• Ophthalmology. 2003 Jun 1; 110 (6): 1137-41.

PurposeTo describe the occurrence of conjunctival ulcers as a manifestation of Behçet's disease.DesignRetrospective, noncomparative, interventional case series with histopathologic correlation.MethodsSix patients who fulfilled the diagnostic criteria for Behçet's disease and presented with painful conjunctival ulcers were included in the study. Three of these ulcers were biopsied and studied histologically and immunohistochemically. The lesions were treated with topical or subconjunctival injection of corticosteroids and, in one case, with oral indomethacin.ResultsAlthough all six patients fulfilled the diagnostic criteria for Behçet's disease, two developed uveitis and other signs of Behçet's disease only months to years after the appearance of the conjunctival ulcers. The 3- to 5-mm, round to oval ulcers were located in the limbal and/or bulbar conjunctiva. Histopathology revealed disrupted epithelium, infiltration of both acute and chronic inflammatory cells, and high endothelial venules. Immunohistochemical analysis of the infiltrating lymphocytes revealed primarily T-cell populations admixed with several B cells and CD68-positive histiocytes. After treatment, the conjunctival lesions invariably healed without scarring.ConclusionsIn addition to the oral and genital ulceration, ulcers can also be found in the conjunctiva of patients with Behçet's disease. Although this is a rare clinical sign, when accompanied by uveitis or orogenital ulcers, it may suggest a diagnosis of Behçet's disease.

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