Retinal thickness profiles in patients with Behçet uveitis during remission

The purpose of this study was to evaluate the intraretinal layer thickness in the macular region and its correlation with the duration of uveitis and visual acuity in patients with Behçet uveitis.

Methods:

In this cross-sectional study, we included 93 eyes of 57 patients with Behçet uveitis and 100 eyes of 50 healthy individuals admitted to a tertiary center from January to September 2017. We performed macular measurements in all subjects via spectral domain-optical coherence tomography (SD-OCT) and divided the retina into layers using automated segmentation software on the SD-OCT device. We then compared layer thicknesses between the patient and control groups and evaluated the correlation between OCT parameters and the duration of uveitis and visual acuity in the patient group.

Results:

Our records show a mean age of 37.9 ± 10.8 (18-64) years and 37.7 ± 12.2 (21-61) years in the patient and control groups (p=0.821), respectively. Meanwhile, data reveal a mean duration of uveitis of 6.9 ± 4.7 (1-20) years. We found a reduction in the total outer layer thickness in the patient group (p<0.001). However, we did not find a statistically significant difference in the inner retinal layers except in the inner nuclear layer. The duration of uveitis negatively correlated with the outer retinal layer’s thickness (correlation coefficient = -0.250). On the other hand, visual acuity positively correlated with the central macular, the total inner layer, and the outer retinal layer thicknesses (correlation coefficients: 0.194, 0.154, and 0.364, respectively). However, the inner nuclear layer negatively correlated with visual acuity.

Conclusions:

Using retinal segmentation via SD-OCT for follow-ups can help estimate visual loss in patients with Behçet uveitis, which can cause significant changes in intraretinal layers in the macular region.

Keywords:
Behçet disease; Behçet uveitis; Intraretinal layers; Optical coherence tomography; Retinal segmentation

	Patient group	Control group	p-value
Patient n/eye n	57/93	50/100
Mean age (y) ± SD	37.9 ± 10.8	37.7 ± 12.2	0.821
Gender F/M	40/17	34/16	0.973
Mean duration of uveitis (y) ± SD	6.9 ± 4.7	N/A
Median spherical equivalent (min to max)	−.25 (−3.00 to +3.00)	−.5 (−3.00 to +4.00)	0.085
Median BCVA (min–max)	0.9 (0.01-1.0)	1.0 (.9-1.0)	0.000

	Patient	Control	p-value
CMT, μam; mean ± SD	261.8 ± 37.3	270.4 ± 25.1	0.106
Macular RNFL, µm; median (min-max)	12 (3-33)	12 (7-24)	0.290
Ganglion cell layer, µm; median (min-max)	15 (5-50)	15 (8-54)	0.928
Inner plexiform layer, µm; median (min-max)	20 (14-43)	20 (14-48)	0.977
Inner nuclear layer, µm; median (min-max)	20 (8-55)	18 (9-51)	0.003
Total inner layer thickness, μam; mean ± SD	175.6 ± 35.9	180.9 ± 26.3	0.211
Total outer layer thickness, µm; median (min-max)	87 (74-103)	90 (76-96)	<0.001

	Duration of uveitis	Visual acuity
CMT (µm)	−0.055 (p=0.696)	*0.194 (p=0.007)**
Macular RNFL (µm)	0.037 (p=0.794)	−0.017 (p=0.812)
Ganglion cell layer (µm)	0.064 (p=0.648)	0.022 (p=0.758)
Inner plexiform layer (µm)	0.062 (p=0.660)	0.078(p=0.280)
Inner nuclear layer (µm)	0.177 (p=0.206)	−0.186 (p=0.010)**
Total inner layer thickness (µm)	−0.024 (p=0.864)	*0.154 (p=0.032)**
Total outer layer thickness (µm)	*−0.250 (p=0.018)**	0.364 (p=0.000)**

Predictors	Beta	Sh	t	p-value
CMT (µm)	−0.014	0.010	−1.410	0.160
Inner nuclear layer (µm)	−0.006	0.002	−3.101	0.002
Total inner layer thickness (µm)	0.016	0.010	1.554	0.122
Total outer layer thickness (µm)	0.011	0.010	1.117	0.266
EZ disruption	−0.191	0.047	−4.066	0.000
IZ disruption	−0.228	0.040	−5.710	0.000
ELM disruption	0.001	0.054	0.025	0.980

	Conventional (n=44)	Interferon (n=13)	Anti-TNF (n=18)	No treatment (n=18)	p-value
CMT, µm; median (min-max)	257 (202-313)	266 (188-324)	246 (173-325)	266 (210-307)	0.494
Macular RNFL, µm; median (min-max)	12 (8-22)	12 (8-33)	13 (8-20)	12 (6-19)	0.950
Ganglion cell layer, µm; median (min-max)	15 (7-48)	14 (8-50)	15 (5-30)	13 (8-29)	0.927
Inner plexiform layer, µm; median (min-max)	20 (14-38)	20 (14-43)	21 (14-42)	20 (15-33)	0.949
Inner nuclear layer, µm; median (min-max)	19 (13-42)	17 (11-39)	19 (8-55)	21 (13-33)	0.814
Total inner layer thickness, µm; median (min-max)	172 (119-281)	179 (109-243)	163 (94-250)	177 (128-222)	0.544
Total outer layer thickness, µm; median (min-max)	87 (79-103)	84 (74-103)	86 (74-98)	87 (79-95)	0.543

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[1] Corresponding author: Hilal Eser-Ozturk. E-mail: hilaleser@yahoo.com