Abstract
Purpose :
Occlusive retinal vasculitis is the most common ocular manifestation of Behçet's Disease (BD). In such cases, OCT-angiography (OCT-A) evaluates the retinal vascular plexus and microperimetry can assess macular sensitivity. We performed a cross-sectional structural and functional study of the parafoveal retina in Behçet's uveitis (BU) patients, comparing them to age- and sex-matched non-ocular BD (NOBD) and healthy subjects (HS).
Methods :
Of 151 potentially eligible patients that met the International Criteria for Behçet's Disease (2014), 45 presented ocular involvement. We enrolled 75 eyes from 14 patients with BU (mean age 40.6 ± 11.7 years), 13 with NOBD (41.2 ± 8.7), and 13 HS (39.9 ± 11.1) in this study. Thirty-one patients were ineligible by refusal, inability to acquire OCT-A images, or neuro/retinopathies. All BU patients had inactive retinal vasculitis evaluated on fluorescein angiography. We analyzed foveal avascular zone (FAZ) area and vessel density (VD) in superficial vascular plexus (SVP), intermediate capillary plexus (ICP), and deep capillary plexus (DCP) with Spectralis® (Heidelberg Engineering, Heidelberg, Germany) (Figure 1A). They were measured using ImageJ (NIH, Maryland, USA) (Figure 1B). The MP-3 microperimeter (Nidek, Tokyo, Japan) evaluated macular sensitivity (MS). In addition, we also compared the groups' retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), and full-thickness retina (FTR). This study had Institutional Ethics Committee approval.
Results :
Variance analysis showed reduction (p < 0.05) in parafoveal VD in DCP in BU patients (Figure 1C), especially in the nasal quadrant (~ 20%) (Figure 1D). There was thinning in nasal (< 25.5%) and inferior (< 17%) GCL thickness, as well as in superior (< 6.8%), nasal (< 13.8%), and inferior (< 7.9%) FTR (Figure 2A). FAZ area and VD in the SVP and ICP did not differ between the groups (Figure 2B). MS was generalized reduced with a predilection to the nasal quadrant (~ 40%) (Figure 2C). Non-perfusion areas (34.8%) and microvascular abnormalities (78.2%) were observed in all plexuses and were more visible in the DCP (Figure 2D-F).
Conclusions :
In patients with BU, vasculitis primarily affects the DCP, structural and functional macular changes are more critical in the nasal quadrant, MS loss may occur even if there is no structural damage, and qualitative vascular findings seem to be a promising diagnostic biomarker.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.