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Title

Retinal vasculitis: a challenging case

Purpose	To report a diagnostic pitfall in a case of retinal vasculitis Methods: Observational report of a Caucasian male diagnosed as Behçet’s disease (BD), presenting with a branch retinal artery occlusion.
Methods	Observational report of a Caucasian male diagnosed as Behçet’s disease (BD), presenting with a branch retinal artery occlusion.
Results	A 25-year-old man presented with unilateral vision loss. He presented with a trace of cells, a superior branch retinal artery occlusion, vasculitis and macular edema. In his antecedents he reported a deep vein thrombosis (DVT), the presence of pretibial subcutaneous nodules and positive genotyping of B51. BD was diagnosed. Although suggestive, the criteria for BD were not fulfilled. The ocular arterial occlusion with low grade inflammation, the history of orchitis, the normal renal function, the negative ANCA’s and the biopsy proven cutaneous vasculitis of medium-sized arteries, fit well with the diagnosis of PAN. The treatment is based on the use of systemic steroids and immunosuppressants, primarily azathioprine. However, some cases are refractory to this treatment and respond well to biologics.
Conclusion	PAN is a necrotizing vasculitis of medium-sized arteries. BD is a systemic vasculitis that involves arteries and veins of any size. The diagnosis of BD is only supported by clinical criteria. Although HLA-B51 is a strongly associated risk factor for BD, there are no pathognomonic laboratorial findings of BD. Ocular vasculitic syndromes require a multidisciplinary approach and the exclusion of other diagnoses based on clinical presentation.
Conflict of interest	No

Authors 1

Last name	JADNANANSING
Initials	A
Department	Faculty of Medicine, Ghent University
City	Ghent

Authors 2

Last name	TERRYN
Initials	W
Department	Department of Nephrology, Jan Yperman Hospital
City	Ieper

Authors 3

Last name	STOCKMAN
Initials	A
Department	Department of Dermatology, AZ Delta Hospital
City	Roeselare

Authors 4

Last name	DE SCHRYVER
Initials	I
Department	Department of Ophthalmology, Ghent University Hospital
City	Ghent