Inner Retinal Microvasculature Damage Correlates With Outer Retinal Disruption During Remission in Behcet's Posterior Uveitis by Optical Coherence Tomography Angiography

PURPOSE. To quantify the inner retinal vascular changes that occur in the superficial and deep layers in patients with Behcet's disease (BD) in remission using optical coherence tomography angiography (OCTA) and to evaluate the associations with outer retinal structure. METHODS. Nineteen eyes from 19 patients with BD in remission were enrolled, including 10 eyes with less than five ocular attacks (n < 5) and nine eyes with five or more attacks (n > 5). The foveal avascular zone (FAZ) and global and regional vessel density (VD) in both layers were compared between BD eyes and normal eyes. Their outer retinal structure, including integrity of the ellipsoid zone (EZ), interdigitation zone (IZ), and outer retinal layer thickness were evaluated. Associations between the inner retinal vasculature and outer retinal disruption were sought. RESULTS. Compared to normal eyes, except for the nasal region, all deep capillary VD values were lower in the BD groups, especially in the inferior region. In the superficial layer, the VD differences between groups were larger in capillaries than in small vessels. The FAZ in the n >= 5 group was larger than that in normal and the n < 5 groups in the deep layer. Greater disruption of EZ and IZ was correlated with decreasing global and regional deep capillary VD. CONCLUSIONS. BD Patients in remission had significant changes in the inner retinal vasculature that corresponded to the outer retinal disruption. Quantitative measurement by OCTA and algorithm might be useful for evaluation of the vasculature and pathologic changes in BD.