Purpose:
To investigate the influence of retinal vasculitis associated with ocular Behcet disease on visual acuity(VA) according to fluorescein angiographic(FA) findings.
Methods:
A retrospective analysis of 54 consecutive patients with Behcet retinal vasculitis was performed to examine the relationship between VA and the FA characteristics (anatomic location, extent of vascular leakage, severity of optic disc leakage, macular and retinal vascular leakage). Correlation between macular leakage and OCT findings was also investigated.
Results:
86 eyes of 48 patients (27 male, 21 female; mean age 35.6 ± 10.2 years) were enrolled in the study. There was a posterior pole involvement of retinal vasculitis in 63 eyes(73.3%) and isolated peripheral involvement in 23 eyes(26.7%). Optic disc involvement was noted in 71 eyes (partial staining 39.5%, diffuse staining 33.7%, and severe leakage with blurring of papillary vasculature 9.3%). Diffuse pattern of vascular leakage was found in 68 eyes(79.1%) and macular leakage in 18 eyes(20.9%). The mean VA for eyes with posterior pole involving vasculitis was significantly worse than for eyes with peripheral vasculitis. (p < 0.0001). Subgroup analysis based on the anatomic location revealed a significant trend toward more severe and diffuse pattern of vascular leakage in posterior pole involving retinal vasculitis compared to peripheral vasculitis.(All p<0.0001), but no difference in optic disc leakage.(p = 0.108). Macular leakage was observed in 51 eyes(80.9%) with posterior pole involving vasculitis, which also showed a significant correlation with VA, mean central retinal thickness and central retinal volume measured on OCT.(All p<0.05) During the follow up, 8 eyes of posterior pole vasculitis without macular leakage eventually developed cystoid leakage. Only one eye (4.3%) with peripheral vasculitis progressed into posterior pole involving vasculitis. A significantly higher portion of eyes with posterior pole involving vasculitis have received systemic immunosuppressants compared to peripheral vasculitis. (p<0.05).
Conclusions:
Posterior pole involvement of retinal vasculitis seems to have a significant impact on VA in patients with retinal vasculitis in ocular Behcet disease.
Keywords: uveitis-clinical/animal model • retina • inflammation