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Mirjam EJ Van Velthoven, Lisette Smid, Tom Missotten, Jan van Laar, Koenraad Arndt Vermeer; Retinal microvasculature in Behçet’s disease measured with optical coherence tomography angiography. Invest. Ophthalmol. Vis. Sci. 2020;61(7):2095.
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© ARVO (1962-2015); The Authors (2016-present)
Behçet’s disease (BD) is generally considered a systemic vascular auto-inflammatory vasculitis that affects multiple organs. Up to 70% of the patients develop uveitis, most commonly presenting as occlusive retinal vasculitis. Since BD is a vasculitis, preclinical retinal microvascular changes in non-ocular BD (NOBD) patients may occur. Our aim was to compare quantitative OCT angiography (OCT-A) measurements of the parafoveal microvasculature in retinal capillary plexuses between Behçet uveitis (BU) patients, NOBD patients, and healthy volunteers (HV).
Sixty-eight subjects were enrolled in this case-control study. Spectralis OCT-A imaging was performed (Heidelberg Engineering, Heidelberg, Germany). A custom MATLAB (The MathWorks Inc, Natick, Massachusetts) algorithm was developed to calculate the vessel density (VD, %) in three retinal vascular layers: deep capillary plexus (DCP), intermediate capillary plexus (ICP) and superficial vascular plexus (SVP). A single foveal avascular zone (FAZ, mm2) and acircularity index (AI) were calculated for all retinal vascular plexuses. Statistical analysis was performed using a one-way MANCOVA (for VD), and a one-way ANOVA (for FAZ and AI), and post hoc tests were performed with Bonferroni correction.
We analyzed one eye from 21 BU (age 51±10 years), 23 NOBD (48±14 years) and 22 HV (44±13 years) subjects. One-way MANCOVA showed a statistically significant difference of the VD between the groups when combining the retinal vascular layers after controlling for scan quality (p<0.0001). Figure 1A shows the differences of the VD between the groups for each of the retinal vascular layers separately. The FAZ area was also statistically significant different between the groups (p<0.005). However, no statistically significant differences were found for the AI. Figure 1B shows the FAZ area and AI for each group.
The retinal microvasculature is not only affected in BU patients, but also in NOBD patients. The deeper layers of the retina in NOBD deviate more from normal microcirculation than SVP as indicated by the VD results. The quantitative VD measurement was the most sensitive measurement for microvascular changes in BD.
This is a 2020 ARVO Annual Meeting abstract.
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