Título

OCTA BIOMARKERS AND MICROPERIMETRY FEATURES IN BEHÇET'S RETINAL VASCULITIS

Objetivo

Occlusive retinal vasculitis is the primary ocular manifestation of Behçet's disease (BD). OCT angiography (OCTA) is very useful to assess the retinal vascular plexus and microperimetry the macular sensitivity. Therefore, we evaluated macular structure and function in a cross-sectional comparison between Behçet's uveitis (BU) and age- and sex-matched non-ocular BD (NOBD) and healthy subjects (HS).

Método

Of 151 eligible patients that met the International Criteria for BD (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. Fluorescein angiography ruled out active retinal vasculitis. Thirty-one eyes were ineligible for this study. 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). In addition, we measured VD with ImageJ (NIH, Maryland, USA) (Fig. 1B) and MP-3 (Nidek, Tokyo, Japan) evaluated the macular function. The institutional ethics committee approved this study.

Resultado

Variance analysis showed (p < 0.05) a reduction (16.8%) in parafoveal VD in DCP in BU patients (Fig. 1C), especially in the nasal quadrant (23.6%) (Fig. 1D). There was also thinning in nasal (22.4%) and inferior (14.9%) GCL thickness, as well as in the superior (6%), nasal (13.2%), and inferior (7.5%) full-thickness retina (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 (23.6%). All plexuses presented non-perfusion areas (35%) and microvascular abnormalities (78%) (Fig. 2D-F).

Conclusão

In patients with BU, vasculitis mainly affects the DCP, macular dysfunction may occur without structural damage, changes are more critical in the nasal quadrant, and qualitative findings seem to be a promising diagnostic biomarker.