Evaluation of macular vascular changes in Behçet's Disease using optical coherence tomography angiography

Purpose: The purpose of the study was to describe macular vascular changes in patients with Behcet's disease (BD) using optical coherence tomography angiography (OCTA) and to compare these findings with those of fluorescein angiography (FA). Patients and Methods: This was a comparative, cross-sectional study. Patients with BD presenting with active uveitis were evaluated using FA and swept-source OCTA. 3 mm × 3 mm and 6 mm × 6 mm en-face images were reviewed and analyzed. Foveal avascular zone (FAZ) areas and vessel densities were also reported. Results: Twenty-five patients (39 eyes) were included. OCTA was superior to FA in showing macular microvascular changes which include areas of retinal capillary hypoperfusion, perifoveal capillary plexuses disruption and capillary abnormalities (including rarefied, dilated, or shunting vessels) were observed more frequently using OCTA than FA. Areas of retinal capillary hypoperfusion were more frequently observed in the deep than in the superficial capillary plexus (SCP). Capillary abnormalities and disorganization of the normal architecture of the capillary network were more frequent in the deep than in the SCP. FAZ area measured in the SCP was significantly larger in eyes with BD than in the control group in both the superficial and the deep capillary plexuses (DCPs). Capillary vessel density measured in the SCP was significantly lower in eyes with BD than in control group in all quadrants of the macula except the nasal sector and the central circle. Conclusion: OCTA allows better identification and description of perifoveal microvascular changes than FA in eyes with active BD. The DCP is more severely involved than the SCP.