Macular inner retinal layer thickening and outer retinal layer damage correlate with visual acuity during remission in behcet’s disease

Abstract

PURPOSE. To identify macular intraretinal layer changes of patients in remission from Behcet’s disease (BD) of short and long duration and evaluate the associations with visual acuity (VA). METHODS. Thirty-two eyes from 26 BD patients were enrolled, including 16 eyes with a duration less than 3 years (0.5-2.5 years; BD1) and 16 eyes of longer duration (3-12 years; BD2). Their intraretinal layer thicknesses and integrity of ellipsoid zone (EZ) and interdigitation zone (IZ) were evaluated by spectral-domain optical coherence tomography (SD-OCT). Associations between VA and retinal structural changes were analyzed. RESULTS. Compared to controls, the inner retina was significantly thicker in BD groups, especially the nerve fiber layer (NFL). The outer retinal layer (ORL) was thicker in BD1 in the central and temporal regions and thinner in BD2 compared to controls in all regions. In BD2, there were more eyes with disruption of the EZ and IZ. Worsening VA was correlated with thickening of the NFL and inner nuclear layer (INL), thinning of the ORL, and greater disruption of the EZ and IZ. Multiple linear regression analysis revealed EZ disruption, nasal ORL, inferior NFL, and temporal and nasal INLs were independent predictors of bestcorrected (BCVA). CONCLUSIONS. Behcet’s disease patients in remission had significant changes in the inner and outer retinal structures, associated with worse VA. Thickness and integrity of the intraretinal layers by SD-OCT and segmentation might be useful predictors for the degree of VA damage in BD remission.