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

• Kim M
• Kwon HJ
• Choi EY
• Kim SS
• Koh HJ
• Lee SC

• KMID: 2366352
• DOI: http://doi.org/10.3349/ymj.2015.56.4.1087

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.

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  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).

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  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).

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  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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