Behcet's Disease with Retinitis Responsive to Prednisone and Adalimumab

This 20 year old woman had Behcet's disease with retinitis that responded rapidly to oral prednisone and subcutaneous injection of adalimumab. A - Initial fundus appearance of retinitis. The yellow arrow indicates white paravascular retinitis. Subretinal fluid is present but is difficult to appreciate in this photograph (see OCT, panel C). B - One month after beginning oral prednisone 40 mg/day and after one injection of subcutaneous adalimumab, the retinitis has regressed, as has the subretinal fluid. The blue arrow indicates residual retinal pigment epithelial metaplastic changes. C - An optical coherence tomograph line scan showing the retinal edema and subretinal fluid (orange arrow) at the initial presentation. D - One month after treatment, the edema and subretinal fluid have resolved. The retinal pigment epithelial metaplasia is indicated by the red arrow.