title: Use of ultra-wide-field retinal imaging in the management of active Behçet retinal vasculitis.
abstract: BACKGROUND
  Retinal vasculitis (RV) is an important component of Behçet disease. It may be difficult to detect either clinically or with conventional retinal imaging. The role of ultra-wide-field (UWF) retinal imaging was assessed in the diagnosis and management of RV associated with Behçet disease.
  
  
  METHODS
  A total of 38 eyes of 20 patients with active RV associated to Behçet disease underwent UWF imaging with the Optos scanning laser ophthalmoscope, fundus autofluorescence, and/or fluorescein angiography. This study determined the UWF findings and percentage of patients in whom this imaging modality assisted in diagnosing the extent of vasculitis, planning treatment, and monitoring disease activity.
  
  
  RESULTS
  Optos UWF imaging assisted in diagnosing and quantifying the extent of RV in 16 patients (80%), planning medical treatment or laser photocoagulation in 13 of 20 patients (65%), and enhanced disease monitoring in 11 of 20 patients (55%). UWF fluorescein angiography revealed vasculitis not clinically evident in 28 of 33 eyes (84.8%). Predominant angiographic findings were diffuse vascular leakage (75.7%), peripheral retinal nonperfusion (66.7%), optic disk leakage (63.6%), macular leakage (30.3%), and macular edema (27.3%). Eighteen patients (34 eyes) underwent UWF fundus autofluorescence, showing multiple hyperfluorescent spots in retinal periphery in 28 eyes (82.3%).
  
  
  CONCLUSIONS
  Ultra-wide-field imaging is a valuable tool in the management of patients with RV associated to Behçet disease and can be used for the diagnosis, treatment, and follow-up. Additional studies, including longitudinal evaluations, are needed to elucidate whether these findings or the subsequent management alterations may improve patients' outcomes.
authors.affiliation: Uveitis Unit, Department of Ophthalmology, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain.
authors.forename: Marina
authors.initials: M
authors.lastname: Mesquida
authors.forename: Victor
authors.initials: V
authors.lastname: Llorenç
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Fontenla
authors.forename: Manuel Javier
authors.initials: MJ
authors.lastname: Navarro
authors.forename: Alfredo
authors.initials: A
authors.lastname: Adán
mesh_terms: D000328:Adult; D000368:Aged; D001528:Behcet Syndrome / Q000175:diagnosis* / Q000188:drug therapy; D002199:Capillary Permeability; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008269:Macular Edema / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D009887:Ophthalmoscopy; D061848:Optical Imaging; D015861:Retinal Neovascularization / Q000175:diagnosis / Q000188:drug therapy; D031300:Retinal Vasculitis / Q000175:diagnosis* / Q000188:drug therapy; D012171:Retinal Vessels / Q000473:pathology; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents