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Structural evaluation of posterior pole in patients with Behçet's disease

PURPOSE: To evaluate demographic findings, ocular manifestations, vascular and morphological changes by fluorescein and indocyanine green angiography and optical coherence tomography of retina and choroid in cases of ocular Behçet's disease. METHODS: Medical records were reviewed to obtain data from 16 patients with Behçet's disease who were in inactive phase. All patients underwent ophthalmic examination, simultaneous fluorescein and indocyanine green angiography and optical coherence tomography. They were also divided into two groups according to disease duration. RESULTS: Thirteen females and three males were evaluated. The main findings of ocular exams were narrowing of vessels, cataract, atrophy of the optic disc and macular epiretinal membrane. 62.5% had visual acuity equal to or better than 0.1. The main findings of fluorescein angiography were capillary leak and impregnation of the vascular wall. The most important findings of indocyanine green angiography were hypofluorescent well defined lesions. The main findings of optical coherence tomography were macular epiretinal membrane and retinal atrophy. Analyzing the visual acuity, no statistical correlation was found between gender, disease duration or presence of retinal edema in fluorescein angiography or optical coherence tomography. The increase in macular thickness was not correlated positively with patient age, disease duration or with the visual acuity. Vascular narrowing seen on fluorescein angiography was correlated with longer duration of illness (p=0.033). The remaining test findings were not correlated with disease duration. CONCLUSION: Fluorescein and indocyanine green angiography and optical coherence tomography are valuable tools to assess the posterior pole in Behçet's disease. Despite the apparent clinical control, these tests may show persistent inflammatory activity, which causes progression of visual loss and a significant number of patients with legal blindness.

Behçet syndrome; Uveitis; Choroid; Retina; Fluorescein angiography; Indocyanine green; Tomography


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