Yonsei Med J.  2015 Jul;56(4):1087-1096. 10.3349/ymj.2015.56.4.1087.

Correlation between Fluorescein Angiographic Findings and Visual Acuity in Behcet Retinal Vasculitis

Affiliations
  • 1Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 2Institute of Vision Research, Department of Ophthalmology, Severance Eye and ENT Hospital, Yonsei University College of Medicine, Seoul, Korea. sunglee@yuhs.ac

Abstract

PURPOSE
To identify significant fluorescein angiographic (FA) characteristics associated with visual acuity (VA) in Behcet retinal vasculitis.
MATERIALS AND METHODS
Retrospective review of 86 eyes of 48 patients (age: 35.6+/-10.2 years) with Behcet retinal vasculitis were performed. VA and FA findings as well as correlation between them were assessed.
RESULTS
The mean initial VA of eyes with posterior pole-involved vasculitis (63 eyes; 73.3%) was significantly worse than that of those with peripheral vasculitis (23 eye; 26.7%) (logarithm of the minimum angle of resolution VA: 0.554+/-0.572 vs. 0.078+/-0.148; p<0.0001). Subgroup analysis revealed a more severe and diffuse pattern of vascular leakage in posterior pole-involved vasculitis compared to peripheral vasculitis (p<0.0001). Retinal vascular leakage (beta=0.345; p<0.0001), optic disc hyperfluorescence (beta=0.147; p=0.032), and macular leakage (beta=0.107; p=0.047) were significantly associated with worse initial VA. During the follow up (mean: 33.3+/-17.9 months), the change of leakage showed no significant correlation with change of VA in posterior pole-involved vasculitis (tau=0.199, p=0.092).
CONCLUSION
Posterior pole involvement, the degree of retinal vascular leakage, optic disc hyperfluorescence, and macular leakage are significantly associated with VA in Behcet retinal vasculitis.

Keyword

Behcet retinal vasculitis; ocular Behcet disease; fluorescein angiography; visual acuity

MeSH Terms

Adult
Aged
Behcet Syndrome/*diagnosis
Female
*Fluorescein Angiography
Fluoresceins
Follow-Up Studies
Humans
Male
Middle Aged
Regression Analysis
Retinal Vasculitis/*diagnosis/physiopathology
Retrospective Studies
Visual Acuity/*physiology
Fluoresceins

Figure

  • Fig. 1 An overlayed circle of diameter 5.5 mm was centered on the fovea to define the posterior pole region approximating the superior and inferior temporal vascular arcades in a patient with Behçet retinal vasculitis (the outer circle). The macular region was delineated with another overlayed circle of diameter 1.5 mm centered on the fovea (the inner circle).

  • Fig. 2 Fluorescein angiogram showing focal leakage (A, arrow pointing at a focal leakage site at the infero-temporal quadrant) and diffuse vascular staining and leakage (B) in Behçet retinal vasculitis.

  • Fig. 3 Fluorescein angiograms demonstrating different grades of macular leakage in Behçet retinal vasculitis. Grade 1, incomplete perifoveal hyperfluorescence (A); grade 2, mild 360° hyperfluorescence (B); grade 3, moderate 360° hyperfluorescence with the hyperfluorescent area being approximately 1 disc diameter across (C); grade 4, severe 360° hyperfluorescence with the hyperfluorescent area being approximately 1.5 disc diameters across (D).

  • Fig. 4 Fluorescein angiograms demonstrating different degrees of retinal vascular leakage in Behçet retinal vasculitis. Mild, staining of vessels with minimal leakage (A); moderate, more intense leakage with a distinct vascular margin (B); severe, even greater leakage with blurring of the large vessel margins (C).

  • Fig. 5 Fluorescein angiograms of Behçet retinal vasculitis demonstrating varying degrees of optic disc hyperfluorescence. Partial (A); diffuse with clear disc margin (B); diffuse with blurring of the disc margin (C).


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