Transient superficial retinal infiltrates are a recognised feature of Behçet uveitis, but their capacity to mimic infectious retinitis is under-emphasised. We describe the diagnostic pitfalls and multimodal imaging appearances of these infiltrates, and summarise practical clues for distinguishing them from infectious retinitis. Retrospective case series of five patients with Behçet uveitis who developed multiple transient superficial retinal infiltrates between May 2020 and October 2025. Assessments included visual acuity, slit-lamp examination, fundus photography, fluorescein angiography (FFA), optical coherence tomography (OCT), and in selected cases, OCT angiography (OCTA) and indocyanine green angiography (ICGA). Five patients (3 men, 2 women; aged 24–63 years) were included. The infiltrates were unilateral in all five; in one the underlying uveitis was bilateral. They were present at first presentation in three patients and developed during follow-up in two. Three had been misdiagnosed with infectious uveitis and given empirical antimicrobial therapy before referral; the median interval from first presentation to the correct diagnosis was 3.6 months (range 1.4–7.8). Retinal vascular leakage was present in all patients, was diffuse, and showed no spatial correspondence to the infiltrates. OCT showed hyperreflectivity predominantly of the inner retina with a preserved retinal pigment epithelium (RPE). Inflammatory retinal and vitreous deposits were seen in two patients, and OCTA, performed in one, showed capillary non-perfusion corresponding to the affected retina. All infiltrates resolved within days to weeks without chorioretinal scarring, and recurrences were common. Spontaneous regression with concurrent new lesion formation (Case 1) and residual inner-retinal thinning in near periphery (Case 2) were both documented on imaging. Behçet uveitis can present with transient superficial retinal infiltrates that mimic infectious retinitis. Supportive features include inflammatory retinal and vitreous deposits, resolution without chorioretinal scarring, retinal vascular leakage unrelated in distribution to the infiltrates, and inner-retinal hyperreflectivity with a preserved RPE; none excludes infection, and investigation for infectious causes remains necessary. Recurrent transient superficial retinal infiltrates, particularly when accompanied by subtle retinal vascular leakage without a classic diffuse fern-like pattern, should raise suspicion of Behçet uveitis and prompt directed questioning about recurrent oral and genital ulceration.
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