Evaluation of Posterior Pole with Echography and Optical Coherence Tomography in Patients with Behçet’s Disease

Abstract

Background: In Behçet’s disease posterior segment involvement is very frequent (about 80%). Macular edema is the most commonly observed complication and is related to reduction of visual acuity. The purpose of the study was to evaluate choroidal involvement during posterior vasculitis due to Behçet’s disease. Methods: Thirty eyes (15 patients) presenting with posterior vasculitis due to Behçet’s disease were studied. All patients had been evaluated with optical coherence tomography (Stratus OCT, Zeiss) to evaluate the retinal thickness (RT) and with standardized 8-MHz A scan echography to determine the retinochoroidal thickness (RCT). Echographic evaluation with 10- and 20-MHz probes was performed in all cases. Results: In 7 eyes (23.3%), both RT and RCT were normal. In 5 eyes (16.6%), they were both increased. In the other 18 eyes (60%), the RCT was increased while the RT was normal, thus indicating a thickening of the choroid alone. No significant correlation was found between choroidal thickness and the presence of vitreal abnormalities. Neither increases in RT nor those in RCT were significantly related to visual acuity. No correlation was found between RT or RCT and pharmacological treatment. Conclusion: Choroidal inflammation could often play a primary eti- ological role during posterior vasculitis in Behçet’s disease. Echographic detection of choroidal thickening in patients with Behçet’s disease not presenting with retinal alterations or visual symptoms could represent a useful way to detect an early inflammation, in order to start a proper therapy and to influence the final visual prognosis.

Changes in subfoveal choroidal thickness associated with uveitis activity in patients with Behçet's disease

“…Interestingly, even before SD-OCT became widely used, Iaccarino et al 21 already reported increased choroidal thickness in patients with BD with uveitis. They measured retinal thickness by time-domain OCT and retinochoroidal thickness by echography.…”

Evaluation of the Macular, Peripapillary Nerve Fiber Layer and Choroid Thickness Changes in Behçet’s Disease with Spectral-Domain OCT

“…Iaccarino and his colleagues [7] found an increase in the retinal choroidal thickness in A-scan echographies associated with a normal retinal thickness in OCT in a statistically high percentage of the cases (60%). They suggested that choroidal inflammation was the primary etiological factor during posterior vasculitis in BD.…”

“…In addition, OCT allows for reproducible measurements of choroidal and retinal thickness. To our knowledge, there are few studies in the literature that examine the thickness of the choroid in patients with BD [7–9]. …”

Avaliação estrutural do polo posterior em pacientes com doença de Behçet

“…Nesse estudo, encontrou-se predileção pelo sexo feminino (81,3%), descrita também em outros estudos (18)(19)(20) . Verifica-se pior prognóstico para sexo masculino (4,15) , relacionado ao maior ín-dice de panuveíte em homens (5) .…”

“…Markomichelakis et al (29) , fazem uma revisão de vários artigos que mostram diversos níveis de correlação, fracos e fortes, entre AV e espessura macular. Autores italianos também não encontraram correlação entre espessura macular na OCT e AV (20) . Pesquisadores japoneses correlacionaram a espessura macular com o tempo de doença porém não com a AV ou com a sensibilidade perimétrica da fóvea (30) .…”