Retinal and Conjunctival Vessels in the Diagnosis and Assessment of Behcet's Disease: A New Approach

Abstract

Background and Objective: The study aimed to investigate the alterations of retinal and conjunctival vessels in patients with Behcet's disease (BD). Patients and Methods: In this case-control study, 17 patients (34 eyes) diagnosed with BD and 17 healthy volunteers (34 eyes) matched by age, sex, blood pressure, and intraocular pressure were recruited. Optical coherence tomography angiography examinations were performed to calculate the vessel density of the retina and conjunctiva according to different sizes of vessels and different zones divided by three segmentation methods of the retina: hemispheric segmentation, Early Treatment Diabetic Retinopathy Study, and central annulus segmentation. Results: The vessel densities of the superficial macrovascular ( P = 0.050), superficial microvascular ( P < 0.001), superficial total microvascular ( P < 0.001), deep total microvascular ( P < 0.001), and deep total microvascular ( P < 0.001) were significantly lower in the BD group. The conjunctival vessel density was significantly higher in the BD group ( P < 0.001). The receiver operating characteristic curve analysis showed that the area under the curve of vessel density of the superior right (0.993, 95% CI 0.980–1) and right zones (0.996, 95% CI 0.987–1) were the largest in the superficial and deep retina, respectively. Otherwise, the area under the curve of conjunctival vessel density was 0.728 (95% CI 0.607–0.848). Conclusions: In patients with BD, retinal vessel density decreases, while conjunctival vessel density increases. Optical coherence tomography angiography provides a new noninvasive and quantitative assessment for retinal and conjunctival vessels. [ Ophthalmic Surg Lasers Imaging Retina 2024;55:13–21.]