ASSESSMENT OF CLINICAL FEATURES AND PROGNOSIS IN BEHÇET DISEASE PATIENTS WITH OCULAR MANIFESTATIONS: A Focus on Optical Coherence Tomography and Angiography.

Abstract

To compare retinal microvascular structures in ocular (active/inactive) Behçet disease (OBD) and nonocular Behçet disease (NOB) using optical coherence tomography and optical coherence tomography angiography. This cross-sectional study included patients with active/inactive OBD, NOB, and healthy control subjects. Disease activity was based on clinical findings and fluorescein angiography. Optical coherence tomography and optical coherence tomography angiography assessed retinal, choroidal thicknesses, vessel density and perfusion density, and optic nerve head flow, and foveal avascular zone characteristics. The primary aim was to identify retinal and choroidal microvascular alterations to assess their potential as biomarkers for disease activity and progression. Sixteen active OBD, 38 inactive OBD, 20 NOB, and 33 control eyes were analyzed. Most OBD patients were on stable immunosuppressive therapy. Central macular thickness was significantly lower in the inactive OBD eyes (239.9 ± 42.1 µ m) than in active OBD (275.3 ± 52.3 µ m), NOB (263.3 ± 22.6 µ m), and controls (267.6 ± 23.6 µ m) ( P = 0.000). Inner retinal layer thicknesses were also reduced ( P < 0.05). The mean vessel density and perfusion density were decreased in inactive OBD compared with NOB and controls ( P < 0.05). Active/inactive OBD patients demonstrated significantly higher foveal avascular zone areas and perimeters and significant deterioration in the circularity index at the deep capillary plexus, correlating with visual acuity loss ( P < 0.05). Best-corrected visual acuity was 20/32 (0.63; 0.48 logMAR) in active OBD, 20/36 (0.55; 0.41 logMAR) in inactive OBD, and 20/20 (1.00; 0.00 logMAR) in NOB and controls. Optical coherence tomography and optical coherence tomography angiography identify retinal thinning and vascular loss in OBD, with vessel density, perfusion density, and foveal avascular zone metrics serving as markers of disease activity and visual function.