A visual evoked potential and optical coherence tomography cross-sectional study in patients with Behcet's disease

Previous studies have reported conflicting results regarding visual evoked potential (VEP) and OCT abnormalities in patients with Behçet's disease (BD). This study aimed to address these discrepancies by investigating subclinical optic neuropathy and retinal dysfunction in Behçet's disease using VEP and OCT.

Seventy-five patients with BD and 40 age- and sex-matched healthy controls underwent comprehensive neurological and ophthalmological examinations. VEP was used to assess P100 latency and amplitude, while peripapillary retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thicknesses were measured using OCT. Subgroup analyses were performed according to neurological and ocular involvement.

Mean disease duration was 9 ± 6 years (0-26 years). No significant differences were observed in P100 latency or amplitude between patients with BD and healthy controls, nor between BD subgroups. Subclinical optic neuropathy, defined as prolonged P100 latency exceeding mean + 2 SD, was identified in only one patient (1.33%) in just BD group. Mean RNFL and GCC thicknesses were comparable between groups and subgroups.

Despite its inflammatory nature, silent optic neuropathy detectable by VEP appears to be uncommon in BD. Retinal involvement may not be expected in Behçet's disease patients with mild ocular involvement, no active ocular involvement, and an average disease duration of less than 10 years. Long term follow-up studies involving larger number of patients, especially with neurologic involvement, are needed.