Post-remission retinal microvascular and choroidal thickness changes in eyes with Behḉet’s disease posterior uveitis: an OCTA longitudinal study

Wassef, Amr Mohamed Abdelaziz; Abdelhakim, Mohamad Amr Salah Eddin; Macky, Tamer A.; Raafat, Karim A; Youssef, Mary

doi:10.1007/s10792-021-01968-x

Cited by 12 publications

(8 citation statements)

References 27 publications

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“…We assume this may be favorable effect of adalimumb as improving the deep retinal plexus circulation is crucial for outer retinal layers most importantly the ellipsoid zone integrity and subsequently the final visual prognosis in such sight threatening Behcet uveitis attacks. This was also noted and proved by Wassef et al, [34] who conducted a A prospective longitudinal observational analytic study on patients with active BD and also assessed by OCTA and enhanced depth imaging OCT during activity and after remission, for retinal microvascular and subfoveal choroidal thickness changes. Their Results showed that with remission of active posterior uveitis, capillary density in both layers increased, while the FAZ area increased.…”

Section: Discussionsupporting

confidence: 54%

OCTA Biomarkers in Sight-Threatening Behcet's Disease-Related Uveitis Treated with Adalimumab

WALY¹,

EL-SHEHAWY²,

ALY

2022

The Medical Journal of Cairo University

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Background: The use of adalimumab in the treatment of Behcet's disease-related uveitis has been demonstrated to be safe and effective in a recent large retrospective study. This study aimed to evaluate the effectiveness of OCTA in detecting abnormalities in the retinal microvasculature following remission achieved with adalimumab treatment. Aim of Study:To evaluate retinal microvasculature parameters during Behcet's uveitis (BU) remission status reached post treatment with adalimumab via optical coherence tomography angiography (OCTA), and compares the results with those from healthy eyes.Material and Methods: A total of 10 eyes of 10 BU patients presenting during the remission period (within 12 months) of BU involving the posterior segment were enrolled, as were 20 normal eyes of 20 age and sex-matched healthy participants. OCTA images were analyzed. Foveal avascular zone (FAZ), and vessel densities (VD) were calculated and compared.Results: 10 eyes of 10 BU patients and 20 normal eyes of 20 age and sex-matched subjects were included in the study. At baseline, the all 10 eyes had active retinal vasculitis. Retinal vasculitis resolved in all cases (100%) after starting adalimumab. The mean time to complete resolution of inflammation was 3.4 weeks. None of the patients developed any adverse events associated with adalimumab treatment. The FAZ was higher in the BD group than in the control group (p=0.01). Both the superficial and deep plexuses vessel densities were significantly lower in BD eyes (p<0.05). Conclusion:BD can cause irreversible damage to the retinal circulation affecting both SCP and DCP. OCTA gives a full view of the retinal microvasculature. Adalimumab was effective in preventing irreversible sight-threatening BD. Adalimumab treatment appears to be associated with improvement of the retinal blood flow more evident in the DCP thus provide better final visual outcome for cases with BD uveitis.

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Section: Discussionsupporting

confidence: 54%

OCTA Biomarkers in Sight-Threatening Behcet's Disease-Related Uveitis Treated with Adalimumab

WALY¹,

EL-SHEHAWY²,

ALY

2022

The Medical Journal of Cairo University

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“…However, the rise at the second follow-up was not significant (17.03 vs. 16.25 at baseline, p = 0.15). Furthermore, Hosseini et al, 20 revealed that the mean SFCT in patients with OBD (ocular BD) was significantly greater than in patients without OBD (364.17 ± 93.34 vs 320.43 ± 56.70 µm; P = 0.008). The difference of mean SFCT between the active compared to quiescent phase was not statistically significant (368.12 ± 104.591 vs 354.57 ± 58.701 µm, P = 0.579).…”

Section: Discussionmentioning

confidence: 96%

Evaluation of subfoveal choroidal thikness in patients with posterior uveitis

Elkader

Elhafeez

Mohamed

2022

ijhs

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Background: Posterior uveitis can have inflammation involving the retina and choroid along with inflammation adjacent structures such as vitreous, optic nerve head, retinal vessels. Aim and objectives: The main aim of this study was to detect the changes in subfoveal choroidal thickness in posterior uveitis using OCT with enhanced depth of focus. Subjects and methods: This prospective study was carried on thirty patients presented with posterior uveitis attending to ophthalmology department of Al azhar university hospitals and Kobry El Qobba Military specialized eye hospital, Cairo, Egypt. The study duration ranged from 6-12 months. Results: as regard the main fundus changes distribution among the studied patients; the most prevalent finding was Chorioretinitis (46.5%) while choroiditis was found in 30.2% and retinitis was found in 23.3%. Also the SFCT was significantly higher in patients than control eyes. Conclusion: increase SCFT may be a clue for detection of sub clinical inflammatory activity of retina and choroid during quiescent phase.

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“…Retinal vascular leakage may be used as a surrogate marker for adalimumab efficacy and may play a role in making treatment decisions. Studies using OCT-A for the assessment of BU reported a significant decrease in foveal density and superficial and deep capillary plexus vessel density (VD), increase in foveal avascular zone (FAZ), parafoveal microvascular alterations, a correlation between visual acuity and VD, correlation between FAZ area and central macular thickness (CMT), as well as correlation of FAZ area and capillary VD with age, BCVA, duration of uveitis, CMT, and FA score (31)(32)(33)(34)(35)(36)(37). One of these studies additionally investigated retinal and choroidal microvascular features in both macular and peripapillary areas of BU (35).…”

Section: Eye Involvementmentioning

confidence: 99%

“…They found a positive correlation with BCVA and peripapillary VD and proposed peripapillary radial capillary density as a novel indicator of disease progression for BU. In a study that compared changes in retinal microvasculature (OCTA) and choroidal thickness (EDI-OCT) during active disease and remission, although deep capillary plexus (DCP) density and FAZ area were more useful as prognostic indicators, superior capillary plexus (SCP) density was more indicative of activity (36). Sub foveal choroidal thickness was an indicator of visual function, but its change did not precisely reveal disease activity.…”

Section: Eye Involvementmentioning

confidence: 99%

Behçet's syndrome: one year in review 2022

Hatemi

Seyahi

Fresko

et al. 2022

Clinical and Experimental Rheumatology

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This review highlights publications on different aspects of Behçet's syndrome (BS) that appeared in 2021 and provides a critical view. These publications include works on the epidemiology of BS across different continents, newly developed instruments to assess damage in BS, studies highlighting the immunopathogenesis, genetics and epigenetic factors, histopathology of the pathergy lesion, clinical and imaging aspects of vascular involvement, and safety and efficacy of therapeutic agents including tocilizumab, apremilast and direct oral anticoagulants.

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Post-remission retinal microvascular and choroidal thickness changes in eyes with Behḉet’s disease posterior uveitis: an OCTA longitudinal study

Cited by 12 publications

References 27 publications

OCTA Biomarkers in Sight-Threatening Behcet's Disease-Related Uveitis Treated with Adalimumab

OCTA Biomarkers in Sight-Threatening Behcet's Disease-Related Uveitis Treated with Adalimumab

Evaluation of subfoveal choroidal thikness in patients with posterior uveitis

Behçet's syndrome: one year in review 2022

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