Behçet's Ocular Disease — RACP Adult Medicine MCQ

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HardRheumatologyBehçet's Ocular DiseaseRACP Adult Medicine

A 30-year-old man presents with recurrent oral and genital ulcers, erythema nodosum, and a positive pathergy test. He now develops sudden onset painful red eye with hypopyon. What is the most appropriate urgent treatment?

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Correct answer: B — Systemic corticosteroids plus infliximab or adalimumab

Behçet's disease with anterior uveitis and hypopyon is a sight-threatening complication requiring aggressive systemic immunosuppression. Posterior uveitis/retinal vasculitis in Behçet's carries a high risk of visual loss. EULAR recommendations advise systemic corticosteroids combined with either azathioprine or anti-TNF therapy (infliximab or adalimumab) for sight-threatening eye disease. Topical steroids alone are insufficient. Colchicine is adequate for mucocutaneous disease but not for ocular involvement.

Reference: eTG – 2025 – Rheumatology; EULAR – 2018 – Behçet's Disease Recommendations