OPTICAL COHERENCE TOMOGRAPHY CHARACTERISTICS OVER TIME IN BEHÇET'S UVEITIS.

Area of Science:

• Ophthalmology
• Medical Imaging
• Immunology

Background:

• Behçet's uveitis (BU) is a systemic inflammatory condition that can affect the eyes, leading to vision loss.
• Macular involvement in BU can cause significant visual impairment.
• Optical coherence tomography (OCT) is a crucial imaging modality for assessing macular pathology.

Purpose of the Study:

• To characterize the macular optical coherence tomography (OCT) findings in patients diagnosed with Behçet's uveitis (BU).
• To investigate the relationship between OCT-identified changes and visual acuity in BU patients.
• To evaluate the temporal evolution and treatment response of macular lesions in BU.

Main Methods:

• Retrospective analysis of OCT images and clinical data from 101 patients (174 eyes) with BU.
• Detailed examination of macular structures, including edema, retinal layers, and RPE/choroidal changes.
• Correlation of OCT findings with visual acuity and assessment of treatment reversibility over time.

Main Results:

• Common OCT findings included cystic macular edema, retinal edema, hyperreflective spots, epiretinal membranes, and foveal atrophy.
• Foveal atrophy, ellipsoid zone (EZ) disruption, RPE disruption, and RPE/choroidal hyperreflection were significantly correlated with reduced visual acuity.
• Aggressive treatment showed partial reversibility of EZ and RPE disruption within 4-12 months, with diminished recovery potential after 2 years.

Conclusions:

• OCT demonstrates severe early-stage macular lesions in Behçet's uveitis.
• Early and aggressive treatment can lead to partial reversal of some OCT abnormalities and potentially improve visual outcomes.
• Advanced stages are characterized by structural disturbances, atrophy, and reflective material deposition in the macula.