Evaluation of posterior pole with echography and optical coherence tomography in patients with Behçet's disease

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.

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.

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.

Choroidal inflammation could often play a primary etiological 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.