Abstract
Purpose
To measure the vascular density (VD) and foveal avascular zone (FAZ) area in patients with Behçet’s disease (BD) obtained by optical coherence tomography angiography (OCTA).
Methods
VD and FAZ area in the deep and superficial retinal vascular networks were measured in all eyes.
Results
Thirty BD and 31 control subjects were included in the study. The mean overall VD measured in the entire scan was lower in BD compared with control group in both the superficial (49.52 ± 6.54 vs 53.57 ± 2.87%, respectively; p = 0.003) and deep (53.44 ± 7.44 vs 58.41 ± 3.01%, respectively; p = 0.002) areas. The FAZ in the BD group was significantly increased at the level of the superficial (0.52 ± 0.67 vs 0.28 ± 0.1 mm2, respectively; p = 0.05) and deep (0.91 ± 1.25 vs 0.39 ± 0.14 mm2, respectively; p = 0.024) areas compared with those of the control group. The deep and the superficial FAZ areas were positively correlated with disease duration and negatively with VA.
Conclusion
In the patients with BD, OCTA showed decreased VD in both the superficial and deep retinal vascular networks. Besides, the VA was correlated with the VD and FAZ.
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References
Yazici H, Fresko I, Yurdakul S (2007) Behçet’s syndrome: disease manifestations, management, and advances in treatment. Nat Clin Pract Rheumatol 3:148–155. https://doi.org/10.1038/ncprheum0436
Sakane T, Takeno M, Suzuki N, Inaba G (1999) Behçet’s disease. N Engl J Med 341:1284–1291. https://doi.org/10.1056/NEJM199910213411707
Tugal-Tutkun I, Onal S, Altan-Yaycioglu R, Huseyin Altunbas H, Urgancioglu M (2004) Uveitis in Behçet disease: an analysis of 880 patients. Am J Ophthalmol 138:373–380. https://doi.org/10.1016/j.ajo.2004.03.022
Cingu AK, Onal S, Urgancioglu M, Tugal-Tutkun I (2012) Comparison of presenting features and three-year disease course in Turkish patients with Behçet uveitis who presented in the early 1990s and the early 2000s. Ocul Immunol Inflamm 20:423–428. https://doi.org/10.3109/09273948.2012.713159
Spaide RF, Klancnik JM, Cooney MJ (2015) Retinal vascular layers imaged by fluorescein angiography and optical coherence tomography angiography. JAMA Ophthalmol 133:45–50. https://doi.org/10.1001/jamaophthalmol.2014.3616
Samara WA, Shahlaee A, Sridhar J, Khan MA, Ho AC, Hsu J (2016) Quantitative optical coherence tomography angiography features and visual function in eyes with branch retinal vein occlusion. Am J Ophthalmol 166:76–83. https://doi.org/10.1016/j.ajo.2016.03.033
Shahlaee A, Pefkianaki M, Hsu J, Ho AC (2016) Measurement of foveal avascular zone dimensions and its reliability in healthy eyes using optical coherence tomography angiography. Am J Ophthalmol 161:50–55.e1. https://doi.org/10.1016/j.ajo.2015.09.026
Samara WA, Say EA, Khoo CT et al (2015) Correlation of foveal avascular zone size with foveal morphology in normal eyes using optical coherence tomography angiography. Retina 35:2188–2195
Khairallah M, Abroug N, Khochtali S, Mahmoud A, Jelliti B, Coscas G, Lupidi M, Kahloun R, Ben Yahia S (2017) Optical coherence tomography angiography in patients with Behcet uveitis. Retina 37:1678–1691
Somkijrungroj T, Vongkulsiri S, Kongwattananon W, Chotcomwongse P, Luangpitakchumpol S, Jaisuekul K (2017) Assessment of vascular change using swept-source optical coherence tomography angiography: a new theory explains central visual loss in Behcet’s disease. J Ophthalmol 2017:2180723. https://doi.org/10.1155/2017/2180723
Chalam KV, Sambhav K (2016) Optical coherence tomography angiography in retinal diseases. J Ophthalmic Vis Res 11:84–92. https://doi.org/10.4103/2008-322X.180709
Yu HG, Kim MJ, Oh FS (2009) Fluorescein angiography and visual acuity in active uveitis with Behçet disease. Ocul Immunol Inflamm 17:41–46. https://doi.org/10.1080/09273940802553279
Takeuchi M, Iwasaki T, Kezuka T, Usui Y, Okunuki Y, Sakai JI, Goto H (2010) Functional and morphological changes in the eyes of Behçet’s patients with uveitis. Acta Ophthalmol 88:257–262. https://doi.org/10.1111/j.1755-3768.2009.01536.x
Yüksel H, Türkcü FM, Sahin M et al (2014) Inner and outer segment junction (IS/OS line) integrity in ocular Behçet’s disease. Arq Bras Oftalmol 77:219–221
Demirtürk OS, Tünel HA, Alemdaroğlu U (2017) Vascular manifestations of Behçet’s disease. Behcets Dis. https://doi.org/10.5772/intechopen.68765
Toussaint D, Kuwabara T, Cogan DG (1961) Retinal vascular patterns. II. Human retinal vessels studied in three dimensions. Arch Ophthalmol 65:575–581
Cogan DG, Kuwabara T (1984) Comparison of retinal and cerebral vasculature in trypsin digest preparations. Br J Ophthalmol 68:10–12. https://doi.org/10.1136/bjo.68.1.10
Coscas F, Glacet-Bernard A, Miere A, Caillaux V, Uzzan J, Lupidi M, Coscas G, Souied EH (2016) Optical coherence tomography angiography in retinal vein occlusion: evaluation of superficial and deep capillary plexa. Am J Ophthalmol 161:160–171.e1–2. https://doi.org/10.1016/j.ajo.2015.10.008
Bradley PD, Sim DA, Keane PA, Cardoso J, Agrawal R, Tufail A, Egan CA (2016) The evaluation of diabetic macular ischemia using optical coherence tomography angiography. Invest Ophthalmol Vis Sci 57:626–631. https://doi.org/10.1167/iovs.15-18034
Wons J, Pfau M, Wirth MA, Freiberg FJ, Becker MD, Michels S (2016) Optical coherence tomography angiography of the foveal avascular zone in retinal vein occlusion. Ophthalmologica 235:195–202. https://doi.org/10.1159/000445482
Di G, Weihong Y, Xiao Z et al (2016) A morphological study of the foveal avascular zone in patients with diabetes mellitus using optical coherence tomography angiography. Graefes Arch Clin Exp Ophthalmol 254:873–879. https://doi.org/10.1007/s00417-015-3143-7
Kahloun R, Ben Yahia S, Mbarek S, Attia S, Zaouali S, Khairallah M (2012) Macular involvement in patients with Behçet’s uveitis. J Ophthalmic Inflamm Infect 2:121–124. https://doi.org/10.1007/s12348-012-0075-9
Kwiterovich KA, Maguire MG, Murphy RP, Schachat AP, Bressler NM, Bressler SB, Fine SL (1991) Frequency of adverse systemic reactions after fluorescein angiography. Results of a prospective study. Ophthalmology 98:1139–1142
Vance SK, Freund KB, Wenick AS, Nguyen QD, Holland GN, Kreiger AE (2011) Diagnostic and therapeutic challenges. Retina 31:1224–1230. https://doi.org/10.1097/IAE.0b013e31820a683a
Taylor SRJ, Singh J, Menezo V, Wakefield D, McCluskey P, Lightman S (2011) Behçet disease: visual prognosis and factors influencing the development of visual loss. Am J Ophthalmol 152:1059–1066. https://doi.org/10.1016/j.ajo.2011.05.032
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This study was financially supported by the Scientific Research Fund of Dicle University (TIP.15.041).
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Türkcü, F.M., Şahin, A., Karaalp, Ü. et al. Automated quantification of foveal avascular zone and vascular density in Behçet’s disease. Ir J Med Sci 189, 349–354 (2020). https://doi.org/10.1007/s11845-019-02051-2
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DOI: https://doi.org/10.1007/s11845-019-02051-2