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Abstract SUMMARY Behçet’s disease (BD) is a systemic vasculitis involving veins and arteries of all sizes, characterized by recurrent exacerbations and remissions (Kone-Paut et al., 2021). The spectrum of the disease is heterogeneous and includes mucocutaneous lesions, arthritis, ocular inflammation, neurologic involvement, and other less frequent manifestations (Bettiol et al., 2020). BD is a chronic disease characterized by recurrent attacks of severe inflammation that may cause significant ocular damage leading to irreversible alterations and significant vision loss (Accorinti et al., 2020). Main causes of serious vision loss in Behçet’s uveitis include optic nerve atrophy, macular damage, and retinal vascular occlusions causing ischemic retinopathy with neovascularization, vitreous hemorrhage, or neovascular glaucoma (Ksiaa et al., 2019). Smoking is the most widespread addiction of mankind. In the cigarette, there are more than 4000 toxic components that affect the vascular and immune system by inducing vasospasm and platelet aggregation and decreasing the antioxidants in the blood (Sweis & Biller, 2017). Smoking is also associated with many ocular diseases, such as dry eye, cataract, Graves ophthalmopathy, age-related macular degeneration, cystoid macular edema (CME), and uveitis (Karbach et al., 2018). Recent studies showed that, contrary to the proinflammatory influence of some components in the cigarette, nicotine has an anti-inflammatory effect by decreasing the cytokine production and alteration of nitric oxide (Gomes et al., 2018). Moreover, it was reported that smoking may cause symptoms of Behçet disease (BD), particularly on mucocutaneous ulcers. On the other hand, it was formerly reported that smoking may have a favorable effect on symptoms of BD, while stopping smoking could activate or aggravate the disease, in particular mucocutaneous lesions (Soriano et al., 2017). These findings highlight the necessity for investigation of the effect of smoking on Behçet uveitis. The current study was designed to investigate the effects of smoking in Behçet uveitis by evaluating the optical coherence tomography angiography (OCTA) findings of smokers & non-smokers Behçet disease (BD) patients. In conclusion, retinal VD decreases and perifoveal microvascular network changes in BD with ocular involvement. However, our results imply that smoking does not have an adverse influence on BD clinical results of uveitis. We believe bigger series are needed to corroborate our results with future follow-up. |