Preclinical ocular features in patients with Behçet’s disease detected by optical coherence tomography angiography

Karalezlı, Aylin; Kaderli, Sema Tamer; Sül, Sabahattin; Pektaş, Suzan Demir

doi:10.1038/s41433-020-01294-z

Cited by 14 publications

(10 citation statements)

References 33 publications

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“…Previous studies have observed that vessel densities of SCP and DCP decreased in comparison with healthy controls in active and remission BD uveitis, indicating the microvascular disruption of retinal plexus in ocular BD (6,7). Recent studies also showed significantly decreased vessel densities in nonocular BD (8,9), while similar vessel densities between nonocular BD and control group were identified by Goker et al (10). A meta-analysis including 6 studies have been demonstrated significantly reduced microvascular perfusion of whole enface, foveal and parafoveal regions in SCP and DCP in non-ocular BD, yet the clinical features of foveal avascular zone (FAZ) and choroidal microvasculature between non-ocular BD and healthy individuals remain unclear (11).…”

Section: Introductionsupporting

confidence: 58%

Retinal and choroidal microvascular alterations in Behcet’s disease without ocular manifestations: A systematic review and meta-analysis

et al. 2022

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PurposeWe performed a systematic review and meta-analysis to examine the microvascular alterations in non-ocular Behcet’s disease (BD) using optical coherence tomography angiography (OCTA).MethodsA comprehensive search was performed in Pubmed, Embase and Cochrane databases for eligible studies from inception to February 2022. Detailed clinical demographics were extracted from each study by two independent reviewers. The weighted mean difference (WMD) and 95% confidence intervals (CI) were used to compare the OCTA parameters between non-ocular BD and healthy controls. Stata 12.0 was adopted to conduct statistical analyses.ResultsTen cross-sectional studies involving 386 eyes in non-ocular BD and 418 eyes in healthy volunteers were ultimately included in the present analysis. When considering superficial capillary plexus (SCP) and deep capillary plexus (DCP), no significant differences of vessel densities in the whole enface image, fovea and perifovea were evaluated between two groups. Significantly reduced parafoveal vessel density of SCP was observed in non-ocular BD in comparison with healthy group (WMD = −1.33, 95%CI: −1.78, −0.89; I2 = 0.6%), while slightly decreased parafoveal vessel density was assessed in DCP (WMD = −1.47, 95%CI: −3.30, 0.35; I2 = 89.3%). Significantly increasing foveal avascular zone (FAZ) area was observed in non-ocular BD when compared to healthy controls (WMD = 0.11, 95%CI: 0.03, 0.19; I2 = 95.3%). There was no significant difference in flow area of choriocapillaris between non-ocular BD and control group (WMD = 0.06, 95%CI: −0.19, 0.32; I2 = 0%).ConclusionBased on current analysis, our results demonstrated significantly lower parafoveal vessel density of SCP and lager FAZ area in full vasculature in non-ocular BD. The retinal microvascular alterations appear before the emergence of ocular manifestations.Systematic Trial Registration[https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42021244856].

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Section: Introductionsupporting

confidence: 58%

Retinal and choroidal microvascular alterations in Behcet’s disease without ocular manifestations: A systematic review and meta-analysis

et al. 2022

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“…Some studies using OCTA showed that both superficial and deep foveal vessel densities (VDs) were significant lower in eyes with BD 16 , 17 , and lower foveal VD was positively correlated with visual acuity 18 . However, other studies found no difference in foveal superficial vascular density between eyes with BD and controls 19 , 20 . Given these inconsistent results, further meta-analyses of published studies should be performed.…”

Section: Introductionmentioning

confidence: 78%

“… Methodological item for non-randomized studies (No. 1–8) Goker et al 16 Çömez et al 17 Türkcü et al 18 Karalezli et al 19 Emre et al 20 Accorinti et al 28 Koca et al 29 Aksoy et al 30 Eser-Ozturk et al 31 Smid et al 32 Cheng et al 33 Yilmaz et al 34 Pei et al 35 1. Is the Case Definition Adequate?…”

Section: Resultsmentioning

confidence: 99%

“…Although available studies have revealed that retinal VDs change in eyes with BD, the related results are inconsistent. For instance, some studies found significantly lower foveal superficial and deep VDs in patients with BD 16 , 17 , while others demonstrated no difference in foveal superficial vascular density 19 , 20 . Given these conflicting results, we conducted this meta-analysis to systemically analyze retinal vessel features in patients with BD.…”

Section: Discussionmentioning

confidence: 99%

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Retinal microvasculature features in patients with Behcet’s disease: a systematic review and meta-analysis

Mei

et al. 2022

Sci Rep

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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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“…Furthermore, several recent publications analyzed with interest changes in retinal microvascularization in BD patients without uveitis, before the emergence of evident clinical findings. Parafoveal microvasculature seems to be involved in BD patients with uveitis and in BD patients without uveitis [ 34 , 35 , 36 , 37 ]; likewise, peripapillary microvascular changes could be detected by OCTA in BD patients without clinical ocular involvement [ 38 ]. FA was performed to ensure absence of any vascular leakage or subclinical vasculitis [ 34 ].…”

Section: Diagnosis Of Uveitis Associated With Behçet’s Diseasementioning

confidence: 99%

Old and New Challenges in Uveitis Associated with Behçet’s Disease

Gueudry

Leclercq

Saadoun

et al. 2021

JCM

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Behçet’s disease (BD) is a systemic vasculitis disease of unknown origin occurring in young people, which can be venous, arterial or both, classically occlusive. Ocular involvement is particularly frequent and severe; vascular occlusion secondary to retinal vasculitis may lead to rapid and severe loss of vision. Biologics have transformed the management of intraocular inflammation. However, the diagnosis of BD is still a major challenge. In the absence of a reliable biological marker, diagnosis is based on clinical diagnostic criteria and may be delayed after the appearance of the onset sign. However, therapeutic management of BD needs to be introduced early in order to control inflammation, to preserve visual function and to limit irreversible structural damage. The aim of this review is to provide current data on how innovations in clinical evaluation, investigations and treatments were able to improve the prognosis of uveitis associated with BD.

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Preclinical ocular features in patients with Behçet’s disease detected by optical coherence tomography angiography

Cited by 14 publications

References 33 publications

Retinal and choroidal microvascular alterations in Behcet’s disease without ocular manifestations: A systematic review and meta-analysis

Retinal and choroidal microvascular alterations in Behcet’s disease without ocular manifestations: A systematic review and meta-analysis

Retinal microvasculature features in patients with Behcet’s disease: a systematic review and meta-analysis

Old and New Challenges in Uveitis Associated with Behçet’s Disease

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