behet 's disease is a chronic systemic inflammatory disorder that frequently involves oral and/or genital mucosa , ocular uvea and skin . when the central nervous system is predominantly affected , the condition is called neuro - behet 's disease . a few case reports involving behet 's disease have described visual field defects ascribed to cerebral lesions , especially in the lateral geniculate body [ 1 , 2 ] ; however , no case reports have observed lesions in both lateral geniculate bodies . here , we report a neuro - behet 's disease patient whose initial manifestation was visualized as lesions in both lateral geniculate bodies on magnetic resonance image ( mri ) . a 50-year - old man with fever and genital ulceration 3 months earlier noticed visual loss in both eyes when waking . a few days later , the patient visited a neurosurgery hospital where mri revealed abnormal signals in both lateral geniculate bodies ( fig . laboratory data revealed increased serum levels of fibrinogen and crp , an accelerated blood sedimentation rate ( fibrinogen : 446.6 mg / dl , normal : 180350 mg / dl ; crp : 2.47 mg / dl ; blood sedimentation rate : 55 mm / h ) and hla - a26 was positive . lumbar puncture revealed an increased number of cells and elevated levels of interleukin-6 as well as total protein in cerebrospinal fluid ( number of cells : 15/l ; interleukin-6 : 48 pg / ml , normal : 15 pg / ml ; total protein : 72 mg / dl , normal : 40 mg / dl ) . the t2-weighted mri and flair images showed high - intensity lesions in both lateral geniculate bodies ( fig . 1b ) ; however , the size of these lesions was reduced compared with that of previously observed lesions . the posterior end of the optic tracts and lateral geniculate bodies were bilaterally enhanced with gadolinium , but the optic nerves and optic chiasm were not ( fig . f ) . optical coherence tomography showed a macular edema on the left retina ( fig . 2c ) , and fluorescein fundus angiography in both eyes revealed a fernlike fluoro - leak image ( fig . 2d ) , both of which indicated posterior uveitis . because of the presence of three ( aphthous stomatitis , genital ulceration and uveal inflammation ) of the four major symptoms , the patient was diagnosed with an abortive type of behet 's disease and was started on predonisolone ( psl ) at a dose of 0.5 mg / kg , after which he showed a rapid improvement of all symptoms . the lesions in the lateral geniculate bodies had disappeared on mri images taken 2 weeks after treatment onset , and the visual field defects had improved ( fig . methotrexate was added from day 50 at a dose of 6 mg / week and was increased to 8 mg / week on day 70 , while the dose of psl was decreased gradually to 18 mg / day . on day 115 , the patient had an optical attack of behet 's disease ; since this attack , he has been treated additionally with infliximab . two cases with behet 's disease presenting with signal abnormalities in one of the lateral geniculate bodies have been previously reported [ 1 , 2 ] . both cases were diagnosed with behet 's disease a few years earlier and subsequently developed visual field defects , the cause of which was considered ischemic damage from vasculitis . the patients were treated with psl and showed a partial recovery of their visual field defects . unlike these 2 cases , our case had lesions in both lateral geniculate bodies . in addition to behet 's disease , there have been several cases with lesions in both lateral geniculate bodies [ 3 , 4 , 5 ] , in which the underlying disorders were inflammatory bowel disease , acute pancreatitis and anaphylactic shock . although these patients commonly suffered from bilateral incomplete hemianopia , their visual field defects disappeared within half a year in parallel with the healing processes of the primary diseases . thus , the pathogenesis of the lesions in both lateral geniculate bodies in these cases is believed to be related to the underlying disorders , especially the vascular involvement from inflammation . in our case , it is noteworthy that the lesions in both lateral geniculate bodies on mri were a predominant manifestation of behet 's disease , leading to a definitive diagnosis using additional detailed ophthalmologic examinations . based on all of the cases mentioned above , the appearance of lesions in both lateral geniculate bodies on mri may indicate the presence of systemic inflammatory diseases such as behet 's disease and that further examinations are required .
a few case reports involving behet 's disease have described visual field defects ascribed to the lateral geniculate body ; however , no cases of lesions in both lateral geniculate bodies have been reported . 
 a 50-year - old male who had fever and genital ulceration 3 months earlier noticed visual field defects . 
 a t2-weighted mri and flair image showed high - intensity lesions in both lateral geniculate bodies . 
 the posterior end of the optic tracts and lateral geniculate bodies were bilaterally enhanced with gadolinium . because of the presence of three ( aphthous stomatitis , genital ulceration and uveal inflammation ) of the four major symptoms , the patient was diagnosed with an abortive type of behet 's disease and started predonisolone at a dose of 0.5 mg / kg , after which he showed a rapid improvement of all symptoms . 
 the lesions in the lateral geniculate bodies had disappeared on the mri images taken 2 weeks after treatment onset . 
 in addition to behet 's disease , several case reports have observed lesions in both lateral geniculate bodies . 
 their visual field defects disappeared within half a year , in parallel with the healing process of the primary diseases . 
 the pathogenesis of the lesions in both lateral geniculate bodies in these cases is believed to be related to the underlying disorders , especially vascular involvement from inflammation . 
 the appearance of lesions in both lateral geniculate bodies on mri scans may indicate the presence of systemic inflammatory diseases such as behet 's disease , but further examinations are required .