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Retinal microvasculature features in patients with Behcet's disease: a systematic review and meta-analysis. Sci Rep 2022; 12:752. [PMID: 35031636 PMCID: PMC8760269 DOI: 10.1038/s41598-021-04730-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 12/29/2021] [Indexed: 12/22/2022] Open
Abstract
This meta-analysis aimed to analyze retinal microvasculature features in eyes with Behçet's disease (BD) using optical coherence tomography angiography (OCTA). Electronic databases, including PubMed, Web of Science, Embase, and Cochrane Library, were comprehensively searched for published studies comparing retinal microvasculature characteristics between eyes with BD and controls. Continuous variables were calculated using the mean difference (MD) with 95% confidence interval (CI). Review Manager software (version 5.30) was used to conduct statistical analysis. A total of 13 eligible studies involving 599 eyes with BD and 622 control eyes were included in the meta-analysis. The pooled results showed that the macular whole enface superficial and deep vessel density (VD) values measured by OCTA were significantly lower in eyes with BD than in control eyes (superficial VD: MD = - 3.05, P < 0.00001; deep VD: MD = - 4.05, P = 0.0004). The foveal superficial and deep VD values were also significantly lower in the BD group than in the control group (superficial VD: MD = - 1.50, P = 0.009; deep VD: MD = - 4.25, - = 0.03). Similarly, the analysis revealed a significant reduction in the parafoveal superficial and deep VD in eyes with BD than in control eyes (superficial VD: MD = - 3.68, P < 0.00001; deep VD: MD = - 4.95, P = 0.0007). In addition, the superficial and deep foveal avascular zones (FAZs) were significantly larger in patients with BD than in controls (superficial FAZ: MD = 0.06, P = 0.02; deep FAZ: MD = 0.12, P = 0.03). The present meta-analysis found that macular whole enface VD, foveal VD, and parafoveal VD were lower in eyes with BD, and the FAZ was larger in patients with BD. The findings suggest that OCTA can assist clinicians in diagnosing and monitoring the status of patients with BD.
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Smid LM, Vermeer KA, Missotten TOAR, van Laar JAM, van Velthoven MEJ. Parafoveal Microvascular Alterations in Ocular and Non-Ocular Behҫet's Disease Evaluated With Optical Coherence Tomography Angiography. Invest Ophthalmol Vis Sci 2021; 62:8. [PMID: 33666648 PMCID: PMC7938019 DOI: 10.1167/iovs.62.3.8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Purpose To compare quantitative optical coherence tomography angiography (OCT-A) measurements of the parafoveal microvasculature in retinal capillary plexuses among Behҫet uveitis (BU) patients, non-ocular Behҫet's disease (NOBD) patients, and healthy volunteers (HVs). Methods Sixty-eight subjects were enrolled in this prospective observational cross-sectional study. OCT-A imaging was performed using the Heidelberg Engineering Spectralis OCT. A custom algorithm was developed to calculate the vessel density (VD) in three retinal vascular layers: deep capillary plexus, intermediate capillary plexus, and superficial vascular plexus. The foveal avascular zone (FAZ) and acircularity index were calculated for the whole retinal vascular complex. Results We analyzed one eye from 21 BU patients (age, 51 ± 10 years), 23 NOBD patients (age, 48 ± 14 years), and 22 HVs (age, 44 ± 13 years). One-way multivariate analysis of covariance showed a statistically significant difference in VD among the three groups when combining the layers after controlling for scan quality (P < 0.001). The VD was lowest in the BU group and highest in the HV group in all layers. The FAZ area was also statistically significant different among the groups (P < 0.005), with the largest FAZ areas in BU patients and smallest FAZ areas in the HV group. However, no statistically significant difference was found for the acircularity index. Conclusions The parafoveal microvasculature is affected not only in BU patients but also in NOBD patients. Most deviations in the retinal microcirculation in Behҫet patients were found in the deeper layers of the retina by using the quantitative VD measurement.
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Affiliation(s)
- Lisette M Smid
- Rotterdam Ophthalmic Institute, Rotterdam, The Netherlands
| | | | | | - Jan A M van Laar
- Section of Clinical Immunology, Departments of Internal Medicine and Immunology, Erasmus Medical Center, Rotterdam, The Netherlands
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Kadomoto S, Uji A, Arichika S, Muraoka Y, Kido A, Nishijima K, Akagi T, Kawai K, Tsujikawa A. Macular Cone Abnormalities in Behçet's Disease Detected by Adaptive Optics Scanning Light Ophthalmoscope. Ophthalmic Surg Lasers Imaging Retina 2021; 52:218-225. [PMID: 34039187 DOI: 10.3928/23258160-20210330-06] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE Investigations of morphological changes in photoreceptors in Behçet's disease (BD) using adaptive optics scanning light ophthalmoscope (AOSLO) are lacking. The authors aimed to evaluate macular cone density and regularity in BD patients with or without a history of uveitis with good visual acuity (VA). PATIENTS AND METHODS The authors included 16 patients (29 eyes) with BD and 12 healthy volunteers (12 eyes) as controls. All subjects had VA of 20/20 or higher. Subjects underwent AOSLO to evaluate the photoreceptor status including cone density (numbers/mm2) and proportion of hexagonal Voronoi domains. RESULTS Hyporeflective patches that were not detected in color fundus photograph or optical coherence tomography were observed by AOSLO in BD patients both with and without past uveitis history; these were not detected in the control group. Cone density was significantly reduced in BD patients with a history of uveitis compared to controls (P = .002). The proportion of hexagonal Voronoi domains was significantly reduced in BD eyes both with and without history of uveitis relative to controls (P < .001). CONCLUSION Macular photoreceptor damage was observed in BD patients with and without a history of uveitis. [Ophthalmic Surg Lasers Imaging Retina. 2021;52:218-225.].
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BOZALİ E, ERDOĞAN H, DURSUN A, VURAL ÖZEÇ A, TOKER İ, ARICI M. Evaluation Of Foveal Thickness And Macular Choroidal Thickness With Optical Coherence Tomography in Behçet's Disease. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2021. [DOI: 10.33808/clinexphealthsci.764833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Yalçındağ FN, Temel E, Şekkeli MZ, Kar İ. Macular structural changes and factors affecting final visual acuity in patients with Behçet uveitis. Graefes Arch Clin Exp Ophthalmol 2020; 259:715-721. [PMID: 33037921 DOI: 10.1007/s00417-020-04958-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 09/22/2020] [Accepted: 10/01/2020] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To evaluate macular structural changes during the active and remission periods in patients with Behçet uveitis and to further assess the factors affecting final visual acuity. METHODS Clinical records and spectral domain-optical coherence tomography (SD-OCT) findings of patients with Behçet uveitis were retrospectively reviewed. RESULTS Sixty-nine eyes of 35 patients were included in the study. SD-OCT findings in the active uveitis period included epiretinal membrane (ERM) in 26 (37.1%) eyes, ellipsoid zone (EZ) damage in 11 (15.7%), external limiting membrane (ELM) damage in 10 (14.3%), macular atrophy in 6 (8.6%), disruption of retinal pigment epithelium (RPE) in 11 (15.7%), a macular scar in 1 (1.4%), and loss of normal foveal contour appearance in 15 (21.4%). There was macular edema in 23 eyes (32.9%) in the active uveitis period (11 (15.7%) cystoid macular edema, 10 (14.3%) diffuse macular edema, and 7 (10.0%) serous retinal detachment). In the remission period, SD-OCT findings included ERM in 37 (52.9%) eyes, EZ damage in 14 (20%), ELM damage in 14 (20%), macular atrophy in 7 (10%), disruption of RPE in 14 (20.0%), macular scar in 1 (1.4%), and loss of normal foveal contour appearance in 17 (24.3%). The mean central macular thickness in the remission period was significantly lower than in the active uveitis period (p < 0.001). The presence of EZ damage and loss of normal foveal contour appearance in active uveitis period were the independent factors associated with final visual acuity (logMAR) (β = 0.736, p = 0.003; β = 0.682, p = 0.002, respectively). CONCLUSION Ellipsoid zone damage and loss of normal foveal contour appearance are important factors affecting visual acuity in Behçet uveitis.
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Affiliation(s)
- F Nilüfer Yalçındağ
- Department of Ophthalmology, Faculty of Medicine, Ankara University, Mamak Street, 06620, Ankara, Turkey
| | - Emine Temel
- Department of Ophthalmology, Faculty of Medicine, Ankara University, Mamak Street, 06620, Ankara, Turkey.
| | - Mehmet Zahid Şekkeli
- Department of Ophthalmology, Faculty of Medicine, Ankara University, Mamak Street, 06620, Ankara, Turkey
| | - İrem Kar
- Department of Biostatistics, Faculty of Medicine, Ankara University, Ankara, Turkey
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Balbaba M, Ulaş F, Postacı SA, Çeliker Ü, Gürgöze MK. Clinical and Demographic Features of Pediatric-Onset Behçet's Disease and Evaluation of Optical Coherence Tomography Findings. Ocul Immunol Inflamm 2020; 28:606-612. [PMID: 31560571 DOI: 10.1080/09273948.2019.1611875] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To evaluate the clinical characteristics, including spectral domain optical coherence tomography (SD-OCT) findings, of pediatric-onset Behçet's disease (PBD) patients. METHODS Medical records of 23 PBD (15 males and 8 females) and 24 (15 males and 9 females) healthy subjects were evaluated retrospectively. The main outcomes were compared between PBD patients, with and without ocular involvement, and healthy subjects. RESULTS The mean age at onset was 12.00 ± 2.10 years. Mean follow-up period was 25.17 ± 15.36 months (range 6-48). Retinal vasculitis was the most common ocular finding (7 patients). Most of the complications of systemic treatment were associated with long term corticosteroid therapy. There was no significant difference between the mean retinal thickness of the PBD patients and healthy controls (p > 0.05). The mean choroidal thickness was significantly increased in all measured segments of PBD patients with ocular involvement (p < 0.01). CONCLUSION Choroidal thickness of PBD patients with ocular involvement was significantly thicker compared to the PBD patients without ocular involvement and to healthy control subjects.
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Affiliation(s)
- Mehmet Balbaba
- Faculty of Medicine, Department of Ophthalmology, Fırat University , Elazığ, Turkey
| | - Fatih Ulaş
- Faculty of Medicine, Department of Ophthalmology, Bolu Abant Izzet Baysal University , Bolu, Turkey
| | - Sevinç Arzu Postacı
- Faculty of Medicine, Department of Ophthalmology, Fırat University , Elazığ, Turkey
| | - Ülkü Çeliker
- Faculty of Medicine, Department of Ophthalmology, Fırat University , Elazığ, Turkey
| | - Metin Kaya Gürgöze
- Faculty of Medicine, Department of Pediatric Rheumatology, Fırat University , Elazığ, Turkey
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Maitra P, Kumar DA, Agarwal A. Epiretinal membrane profile on spectral domain optical coherence tomography in patients with uveitis. Indian J Ophthalmol 2019; 67:376-381. [PMID: 30777956 PMCID: PMC6407406 DOI: 10.4103/ijo.ijo_650_18] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Purpose: To study the epiretinal membrane (ERM) profile on the spectral-domain optical coherence tomography (SDOCT) in eyes with uveitis. Methods: In this prospective observational study, macula of uveitic eyes were evaluated by SDOCT (Cirrus, model 5000) for ERM. ERM was quantified (in microns) and were followed up along with the best-corrected visual acuity (BCVA) and treatment profile for 1 year. ERM morphology (focal, global, or mixed) and characteristics (thickness at fovea, maximum thickness, and location of maximum thickness in relation to fovea) were documented. Changes in altered foveal contour, cystoid macular edema (CME), and central foveal thickness were also noted. BCVA was noted when the inflammation subsided and it was correlated to specific ERM characteristics. SDOCT characteristics were compared in three treatment groups (no oral steroids, oral steroids with, and without immunomodulators). Results: Thirty-four eyes of 25 patients were evaluated. Mean logMAR BCVA decreased from 0.25 to 0.35 (P = 0.005). Foveal involvement with ERM (P = 0.011), lost foveal contour (P = 0.043), and ellipsoid layer disruption (P = 0.017) were associated significantly with reduced BCVA. Focal attachment of ERM was more commonly associated with CME (P = 0.03). Median ERM thickness showed significant increase (P < 0.001). Significant ERM progression from parafoveal to foveal (P = 0.02), significant progression of the thickest area of ERM closer to fovea (P = 0.0006) indicated a strong tendency of foveal involvement and this was correlated with worse BCVA (P = 0.009, r = −0.44) Oral steroids/immunomodulators showed no significant benefit on ERM progression. Conclusion: ERM progression in uveitis has a tendency to involve the fovea and is associated with significant vision loss, particularly in foveal ERM, focal attachment, and IS-OS disruption. Oral steroids and immunomodulators have no role in halting progression.
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Affiliation(s)
- Puja Maitra
- Department of Uvea and Oncology Services, Dr Agarwal's Eye Hospital, 19 Cathedral Road, Chennai, Tamil Nadu, India
| | - Dhivya Ashok Kumar
- Department of Uvea and Oncology Services, Dr Agarwal's Eye Hospital, 19 Cathedral Road, Chennai, Tamil Nadu, India
| | - Amar Agarwal
- Department of Uvea and Oncology Services, Dr Agarwal's Eye Hospital, 19 Cathedral Road, Chennai, Tamil Nadu, India
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Ksiaa I, Abroug N, Kechida M, Zina S, Jelliti B, Khochtali S, Attia S, Khairallah M. Œil et maladie de Behçet. J Fr Ophtalmol 2019; 42:626-641. [DOI: 10.1016/j.jfo.2018.09.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Accepted: 09/03/2018] [Indexed: 12/30/2022]
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Eye and Behçet's disease. J Fr Ophtalmol 2019; 42:e133-e146. [DOI: 10.1016/j.jfo.2019.02.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 12/25/2018] [Accepted: 02/07/2019] [Indexed: 12/30/2022]
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Kido A, Uji A, Morooka S, Kuroda Y, Arichika S, Akagi T, Tsujikawa A. Outer Plexiform Layer Elevations as a Marker for Prior Ocular Attacks in Patients With Behcet's Disease. Invest Ophthalmol Vis Sci 2019; 59:2828-2832. [PMID: 30025143 DOI: 10.1167/iovs.18-24348] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Patients with Behcet's disease frequently have abnormal focal outer plexiform layer (OPL) bumps, which compress the inner nuclear layer. This study investigates the clinical relevance of these OPL elevations in Behcet's disease patients. Methods Thirty-one consecutive patients (59 eyes) with Behcet's disease in remission and with available optical coherence tomography (OCT) images were included. The number of OPL bumps was counted using spectral-domain OCT images. The relationships between the number of bumps and visual acuity (VA), retinal thickness, choroidal thickness, disease duration, number of prior ocular attacks, and photoreceptor layer status (including external limiting membrane [ELM] and ellipsoid zone [EZ] continuity) were examined. Results Eyes with more severe EZ or ELM disruptions had lower VA, more ocular attacks, and thinner retinas. Additionally, EZ line and ELM line status were significantly correlated with the number of OPL elevations. Eyes with OPL elevations had poorer VA, longer disease duration, more ocular attacks, and thinner retinas than those without OPL elevations. Additionally, the number of OPL elevations was strongly correlated with the number of ocular attacks in eyes with a preserved photoreceptor layer (R = 0.720, P < 0.0001). Conclusions The number of OPL elevations was associated with the number of prior ocular attacks in eyes with preserved photoreceptor layers. Therefore, OPL elevations may be a marker of prior posterior ocular attacks, which is important when determining how best to manage Behcet's uveitis.
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Affiliation(s)
- Ai Kido
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akihito Uji
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Satoshi Morooka
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yoshimasa Kuroda
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shigeta Arichika
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tadamichi Akagi
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akitaka Tsujikawa
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Choroidal thickness in non-ocular Behçet's disease - A spectral-domain OCT study. J Curr Ophthalmol 2017; 29:210-213. [PMID: 28913513 PMCID: PMC5587250 DOI: 10.1016/j.joco.2017.06.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Revised: 06/01/2017] [Accepted: 06/13/2017] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate choroidal thickness in patients with non-ocular Behçet's disease (BD) using spectral domain optical coherence tomography (SD-OCT) and to compare the results to normal eyes. Methods In this retrospective observational comparative study, we collected OCT and clinical data from the charts of 4 patients (7 eyes) with BD who had been referred for a screening eye exam and had a normal ocular examination. Data from 9 healthy volunteers (17 eyes) were collected as age-matched controls. The choroid was manually segmented from volume OCT scans using custom Doheny Image Reading Center OCT grading software (3D-OCTOR). Main outcome measures were choroidal thickness and intensity were compared between eyes of patients with BD and those of healthy controls. Results Eyes of patients with non-ocular BD had significantly thinner mean central subfield choroidal thickness (227.5 ± 56.93 versus 306.85 ± 17.85, P = 0.04) and central subfield choroidal volume (0.18 ± 0.04 vs 0.24 ± 0.02, P = 0.005). There was no significant difference in mean choroidal thickness in the whole ETDRS grid or in mean choroidal intensity in the central subfield and the whole ETDRS grid between eyes of patients with non-ocular BD and those of controls. Conclusion This study demonstrates that BD may have subclinical manifestations in the choroid, resulting in thinning of the choroid relative to normal eyes, even without overt signs of ocular involvement.
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Tugal-Tutkun I, Ozdal PC, Oray M, Onal S. Review for Diagnostics of the Year: Multimodal Imaging in Behçet Uveitis. Ocul Immunol Inflamm 2016; 25:7-19. [DOI: 10.1080/09273948.2016.1205100] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Ilknur Tugal-Tutkun
- Department of Ophthalmology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | | | - Merih Oray
- Department of Ophthalmology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Sumru Onal
- Department of Ophthalmology, Koc University, School of Medicine, Istanbul, Turkey
- Department of Ophthalmology, Vehbi Koc Foundation, American Hospital, Istanbul, Turkey
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Thickness Changes in Foveal, Macular, and Ganglion Cell Complex Regions Associated with Behçet Uveitis during Remission. Eur J Ophthalmol 2015; 26:347-50. [DOI: 10.5301/ejo.5000728] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2015] [Indexed: 12/14/2022]
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Takeuchi M, Harimoto K, Taguchi M, Sakurai Y. Reconstitution of disrupted photoreceptor layer in uveitis associated with Behçet's disease by infliximab treatment. BMC Ophthalmol 2015; 15:177. [PMID: 26653575 PMCID: PMC4676814 DOI: 10.1186/s12886-015-0162-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 12/02/2015] [Indexed: 11/10/2022] Open
Abstract
Background Behçet’s disease (BD)-associated uveitis causes retinal damage leading to severe visual disturbance. The early morphological changes in the retina are revealed by disappearance or disruption of the external limiting membrane (ELM), inner segment ellipsoid zone (EZ) and cone interdigitation zone (CIZ) in the outer retina shown on spectral domain-optical coherence tomography (SD-OCT). However, it is unknown whether these changes in the retina are reversible in BD-associated uveitis. Case presentation A 38-year-old man was referred to our hospital with 5 years history of panuveitis in both eyes. Recurrent oral ulcer, folliculitis, and genital ulcer were noted as systemic complications. Moderate cell infiltration into the anterior chamber, and diffuse vitritis were observed in both eyes, and best corrective visual acuity (BCVA) was 20/60 in the right and 20/200 in the left eye. Fluorescein angiography (FA) showed severe dye leakage from extensive retinal vessels in both eyes. Spectral domain-optical coherence tomography (SD-OCT) revealed retinal cysts and disruption of the external limiting membrane (ELM), inner segment ellipsoid zone (EZ) and cone interdigitation zone (CIZ) in the macular region of both eyes. BD was diagnosed based on the ocular features and systemic lesions, and infliximab therapy was initiated for the severe visual disturbance. After treatment with infliximab, foveal excavation was first recovered with disappearance of retinal cysts, and then ELM and EZ were gradually reconstituted on SD-OCT. Finally, CIZ became distinguishable after 24 months of infliximab therapy. BCVA was recovered to 20/25 in both eyes, and ocular inflammatory attack did not recur after the initiation of infliximab therapy. Conclusion Disruption of ELM, EZ, and CIZ shown on SD-OCT in BD-associated uveitis could be reconstituted by continuous infliximab treatment, which leaded to the improvement of visual acuity.
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Affiliation(s)
- Masaru Takeuchi
- Department of Ophthalmology, National Defense Medical College, 3-2 Namiki, Tokorozawa City, Saitama, 359-8513, Japan.
| | - Kozo Harimoto
- Department of Ophthalmology, National Defense Medical College, 3-2 Namiki, Tokorozawa City, Saitama, 359-8513, Japan.
| | - Manzo Taguchi
- Department of Ophthalmology, National Defense Medical College, 3-2 Namiki, Tokorozawa City, Saitama, 359-8513, Japan.
| | - Yutaka Sakurai
- Department of Ophthalmology, National Defense Medical College, 3-2 Namiki, Tokorozawa City, Saitama, 359-8513, Japan.
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Saxena S, Srivastav K, Cheung CM, Ng JY, Lai TY. Photoreceptor inner segment ellipsoid band integrity on spectral domain optical coherence tomography. Clin Ophthalmol 2014; 8:2507-22. [PMID: 25525329 PMCID: PMC4266419 DOI: 10.2147/opth.s72132] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Spectral domain optical coherence tomography cross-sectional imaging of the macula has conventionally been resolved into four bands. However, some doubts were raised regarding authentication of the existence of these bands. Recently, a number of studies have suggested that the second band appeared to originate from the inner segment ellipsoids of the foveal cone photoreceptors, and therefore the previously called inner segment-outer segment junction is now referred to as inner segment ellipsoidband. Photoreceptor dysfunction may be a significant predictor of visual acuity in a spectrum of surgical and medical retinal diseases. This review aims to provide an overview and summarizes the role of the photoreceptor inner segment ellipsoid band in the management and prognostication of various vitreoretinal diseases.
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Affiliation(s)
- Sandeep Saxena
- Retina Service, Department of Ophthalmology, King George's Medical University Lucknow, India
| | - Khushboo Srivastav
- Retina Service, Department of Ophthalmology, King George's Medical University Lucknow, India
| | | | - Joanne Yw Ng
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong
| | - Timothy Yy Lai
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong
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Evaluation of the Macular, Peripapillary Nerve Fiber Layer and Choroid Thickness Changes in Behçet's Disease with Spectral-Domain OCT. J Ophthalmol 2014; 2014:865394. [PMID: 24868459 PMCID: PMC4020218 DOI: 10.1155/2014/865394] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 04/04/2014] [Accepted: 04/04/2014] [Indexed: 12/14/2022] Open
Abstract
Purpose. To assess the macular, choroid, and peripapillary nerve fiber layer thickness (RNFL) in Behçet's disease (BD) patients with and without ocular involvement by means of optical coherence tomography (OCT) and compare these findings with healthy controls.
Design. Eighty patients with BD and 40 healthy controls who were followed up at the Uveitis and Retina Clinic of the Kayseri Research and Education Hospital in Turkey were enrolled in this prospective study.
Subjects and Controls. The patients with BD were divided into two groups according to the presence of ocular involvement. Group 1 consisted of 40 eyes of 40 patients with ocular involvement and group 2 consisted of 40 eyes of 40 patients without ocular involvement.
Methods. All of the patients and controls underwent macular, choroid, and peripapillary nerve fiber layer thickness analysis with Spectralis domain OCT (Spectralis OCT Heidelberg Engineering, Dossenheim, Germany).
Main Outcome Measures. The differences in macular, choroid, and peripapillary nerve fiber layer thicknesses between groups were analyzed statistically.
Results. Macular thickness was thinner in patients with BD than in the control group; this result was statistically significant (P = 0.05). There was no statistically significant difference in thickness between RNFL analysis of the patients with BD and control subjects. However, the BD patients with ocular involvement had statistically significant thinning in RNFL compared with BD patients without ocular involvement. Although the choroid was thicker in patients with BD than in the control group, it did not reach a statistically significant level (P = 0.382).
Conclusions. BD with ocular involvement may be associated with decreased macular and RNFL thickness measured with spectral-domain OCT.
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Pakzad-Vaezi K, Or C, Yeh S, Forooghian F. Optical coherence tomography in the diagnosis and management of uveitis. Can J Ophthalmol 2013; 49:18-29. [PMID: 24513352 DOI: 10.1016/j.jcjo.2013.10.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 09/27/2013] [Accepted: 10/02/2013] [Indexed: 12/19/2022]
Abstract
Optical coherence tomography (OCT) has become an integral tool in the imaging of numerous diseases of the posterior segment. The diagnostic investigation of infectious and noninfectious uveitic conditions often requires multiple imaging modalities in the appropriate clinical context. Modern OCT technology has proved useful not only in the diagnostic investigation of these conditions, but also in monitoring of their clinical course and therapeutic response. Inflammation-induced changes at the level of the retina, retinal pigment epithelium, and choroid can now easily be identified in these conditions using OCT. Prognostic information on visual acuity outcome can also be estimated based on OCT findings. Numerous OCT findings have been described in the setting of the various uveitides. Although none of these findings appear to be pathognomonic for diagnosis of specific uveitic syndromes, in the appropriate clinical context they can add a great deal of information in the diagnosis and management of uveitis.
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Affiliation(s)
- Kaivon Pakzad-Vaezi
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, B.C
| | - Chris Or
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, B.C
| | - Steven Yeh
- Department of Ophthalmology, Emory Eye Center, Emory University School of Medicine, Atlanta, Ga
| | - Farzin Forooghian
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, B.C..
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Epiretinal membranes in patients with uveitis: morphological and functional analysis with spectral domain optical coherence tomography. BIOMED RESEARCH INTERNATIONAL 2013; 2013:284821. [PMID: 24294602 PMCID: PMC3835473 DOI: 10.1155/2013/284821] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Revised: 09/22/2013] [Accepted: 09/22/2013] [Indexed: 12/04/2022]
Abstract
Purpose. To correlate the uveitic epiretinal membrane (ERM) features using spectral-domain optical coherence tomography (SD-OCT) with visual acuity (VA). Methods. Forty-one eyes of 32 patients were included in this retrospective study. SD-OCT was performed in all patients and data were collected at the time of ERM diagnosis and at the final visit. Both best corrected visual acuity (BCVA) and ERM thickness were correlated with the morphological and clinical features. Results. Final BCVA was positively correlated with male sex (P = 0.0055) and the focal pattern of ERM attachment (P = 0.031) and negatively correlated with IS/OS photoreceptor junction disruption (P = 0.042). BVCA change showed a positive correlation with the age of ERM onset (P = 0.056) but a negative correlation with IS/OS photoreceptor disruption at the ERM diagnosis (P = 0.029) and the increase of central subfield thickness (CST) (P = 0.95). Final ERM thickness correlated with the duration of uveitis (P = 0.0023) and the duration of ERM (P = 1.15 e-05). During the follow-up, ERM thickening correlated with male sex (P = 0.042), posterior uveitis (P = 0.036), uveitis duration (P = 0.026), and broad attachment pattern (P = 0.052). Conclusions. In the uveitic ERM, VA negatively correlates with IS/OS photoreceptor junction disruption and the increase of CST. ERM thickness is influenced by longer duration of both uveitis and ERM.
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Paovic J, Paovic P, Sredovic V. Correlation between Ocular Manifestations and Their Complications as Opposed to Visual Acuity and Treatment in Behcet's Disease. Autoimmune Dis 2013; 2013:842673. [PMID: 24073331 PMCID: PMC3773399 DOI: 10.1155/2013/842673] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Accepted: 07/30/2013] [Indexed: 12/14/2022] Open
Abstract
The aim of this study was to analyze ocular manifestations, their complications, and treatment in a sample of 40 patients with confirmed Behcet's disease. Results. Serofibrinous iridocyclitis was the most common form of uveitis (60%). Retinal periphlebitis manifested in 92.5% of cases, and periphlebitis in conjunction with periarteritis was diagnosed in 72.5% of cases. Macular edema was the most frequent complication on the posterior segment (60%) and it correlated with periphlebitis (P = 0.45) and periphlebitis associated with periarteritis (P = 0.51). Cyclosporine A and corticosteroids were used in the majority of cases (67%). Following six months of therapy, a significant improvement of visual acuity occurred in patients with initial visual acuity >0.5 on both eyes. Level of visual acuity before and after treatment had a strong significant correlation coefficient with various ocular complications. Previously proven significant increase of visual acuity in patients with macular edema depicts effectiveness of treatment in these types of ocular manifestations of Behcet's disease. Conclusions. Significant improvement of visual acuity occurred in patients with initial visual acuity >0.5 on both eyes. The highest increase in visual acuity was achieved by laser photocoagulation in combination with triamcinolone acetonide P = 0.038 < 0.050.
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Affiliation(s)
- Jelena Paovic
- Department of Ophthalmology, University Clinical Center, Pasterova 2, 11000 Belgrade, Serbia
| | - Predrag Paovic
- Department of Ophthalmology, University Clinical Center, Pasterova 2, 11000 Belgrade, Serbia
| | - Vojislav Sredovic
- Uvea Centar, Center for Diagnostic and Treatment of Uveitis, Kneza od Semberije 14, 11000 Belgrade, Serbia
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Coskun E, Gurler B, Pehlivan Y, Kisacik B, Okumus S, Yayuspayı R, Ozcan E, Onat AM. Enhanced depth imaging optical coherence tomography findings in Behçet disease. Ocul Immunol Inflamm 2013; 21:440-5. [PMID: 23895216 DOI: 10.3109/09273948.2013.817591] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE Investigation of subfoveal choroidal thickness in Behçet disease (BD) with enhanced depth imaging optical coherence tomography (EDI-OCT). METHODS The study included 35 patients with posterior uveitis (PU) associated with BD, 35 patients with BD without ocular involvement, and 30 healthy controls. RESULTS There were no significant differences between the groups in terms of age, gender, axial length, or spherical equivalent refractive error. The mean subfoveal choroidal thickness was thinner in eyes with PU than in eyes without PU and healthy controls (p = 0.026). CONCLUSION EDI-OCT is a beneficial test for evaluating choroid morphology in BD. Thinning of the subfoveal choroidal tissue has been observed in patients with BD-associated PU.
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Onal S, Tugal-Tutkun I, Neri P, P Herbort C. Optical coherence tomography imaging in uveitis. Int Ophthalmol 2013; 34:401-35. [DOI: 10.1007/s10792-013-9822-7] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2013] [Accepted: 06/24/2013] [Indexed: 11/28/2022]
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Abstract
PURPOSE OF REVIEW The advancement of optical coherence tomography has improved the resolution of in-vivo images of the retina. This has led to a wealth of novel knowledge regarding the microstructures of the photoreceptor layer and its relationship with visual functions under different pathological diseases. RECENT FINDINGS Identification of the hyperreflective lines in the photoreceptor layer has been made possible by spectral domain optical coherence tomography. The inner segment/outer segment junction, external limiting membrane, cone outer segment tips, and the retinal pigment epithelium were thought to be the origins of the four hyperreflective lines seen in the photoreceptor layer. Integrity of these lines has been linked with visual functions in various retinopathies, and has been suggested to carry prognostic implications. Recovery of initially interrupted lines has been documented following successful treatment. SUMMARY Identification of these hyperreflective lines may have clinical implications as visual function was found to correlate closely with their integrity. Restoration of these lines may indicate treatment response and potential visual recovery.
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Nazari H, Dustin L, Heussen FM, Sadda S, Rao NA. Morphometric spectral-domain optical coherence tomography features of epiretinal membrane correlate with visual acuity in patients with uveitis. Am J Ophthalmol 2012; 154:78-86.e1. [PMID: 22541930 DOI: 10.1016/j.ajo.2012.01.032] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Revised: 01/30/2012] [Accepted: 01/31/2012] [Indexed: 11/25/2022]
Abstract
PURPOSE To identify visually significant spectral-domain optical coherence tomography (SD-OCT) features of epiretinal membranes (ERM) in patients with uveitis. DESIGN Retrospective cohort and cross-sectional study. METHODS Eighty consecutive eyes with uveitis and SD-OCT-documented ERM were included. Clinical data were collected at the time of diagnosis of ERM and at the final visit. SD-OCT images at the last visit were evaluated to identify fovea and ERM configuration and structural changes. Changes of 10% and 20% in central subfield thickness between initial and last SD-OCT were calculated and correlated with visual acuity (VA). An ERM thickness map was created using validated SD-OCT grading software. RESULTS VA improved significantly in eyes with more than 12 months of follow-up (P = .03). Although inflammation activity and medical treatment methods were no different in eyes with more or less than 12 months of follow-up, 16 eyes in the subset with longer follow-up underwent cataract extraction and intraocular lens implantation. Kaplan-Meier analysis demonstrated few vision losses during the follow-up period. Change in central subfield thickness did not correlate with VA. Foveal center involvement (P < .001), focal attachment of the ERM (P = .003), and foveal inner segment and outer segment junction disruption (P = .006) were associated independently with lower VA. ERM was thinner in eyes with 20/40 or better VA (4.6 ± 0.6 μm) compared with eyes with VA of less than 20/200 (P = .02). Longer duration of ERM was associated with thicker ERM (P < .05). CONCLUSIONS In most eyes with uveitis and ERM, VA remains stable if ocular inflammation and comorbidities are addressed appropriately.
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Nishijima K. Geographic pattern of central retinal sensitivity after intravitreal triamcinolone for diabetic macular edema. Graefes Arch Clin Exp Ophthalmol 2012. [DOI: 10.1007/s00417-011-1671-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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