Título

MACULAR STRUCTURE AND FUNCTION STUDY USING OCTA AND MICROPERIMETRY IN PATIENTS WITH BEHÇET’S RETINAL VASCULITIS

Objetivo

To perform a macular structure and function study in patients with Behçet's disease (BD), comparing Behçet's uveitis (BU), non-ocular BD (NOBD), and healthy subjects (HS) groups.

Método

Of 151 eligible patients that met the International Criteria for BD (2014), 45 presented ocular involvement. We enrolled 75 eyes (Table) 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). Fluorescein angiography ruled out active retinal vasculitis. Thirty-one eyes were ineligible. Spectralis® (Heidelberg Engineering, Heidelberg, Germany) analyzed macular thickness, foveal avascular zone (FAZ) area, and vessel density (VD) in superficial vascular plexus (SVP), intermediate capillary plexus (ICP), and deep capillary plexus (DCP) (Fig. 1A). We measured VD with ImageJ (NIH, Maryland, USA) (Fig. 1B) and evaluated the macular function using MP-3 (Nidek, Tokyo, Japan). The institutional ethics committee approved this study.

Resultado

Eighteen eyes (78%) had best-corrected visual acuity ≥ 20/25. Variance analysis showed a 19% reduction (p < .05) in parafoveal VD in DCP in BU (Fig. 1C), especially in the nasal quadrant (Fig. 1D). There was thinning in nasal (24%) and inferior (16%) GCL thickness, as well as in the superior (6%), nasal (14%), and inferior (8%) retinal thickness (Fig. 2A). FAZ area and VD in the SVP and ICP did not differ between the groups (Fig. 2B). MP-3 (Fig. 2C) showed diffuse sensitivity reduction (24%). Outer plexiform layer elevations on OCT were noticed in 2/3 of BU patients, and nonperfusion areas (35%) and microvascular abnormalities (78%) on OCTA were seen in all plexuses (Fig. 2D-F).

Conclusão

BU presented structural and functional macular damage despite good BCVA, mainly affecting the nasal sector and the DCP in multimodal imaging evaluation. The terminal nature of the vessels in DCP may explain these findings. On OCT and OCTA, qualitative and qualitative changes can be valuable biomarkers of occlusive retinal vasculitis in BS.