Investigation of anterior segment structures of the eye in Behcet's disease using in vivo confocal microscopy

Purpose We sought to investigate alterations in the corneal subbasal nerve plexus and endothelium in patients with Behcet's disease (BD). Methods This cross-sectional study included 64 patients with BD and 30 age- and gender-matched healthy control subjects. Those with BD were classified as having ocular or non-ocular disease. All subjects underwent a corneal endothelial and subbasal nerve density evaluation using in vivo confocal microscopy (IVCM). The differences among groups were analyzed using the Kruskal-Wallis test followed by Dunn's multiple comparison procedure. Results The mean age of study participants was 35.7 +/- 10.2 years (16-58) in the ocular BD group, 39.6 +/- 14.9 years (11-66) in the non-ocular BD group, and 34.1 +/- 11.2 years (21-55) in the control group. No statistical significance was found in terms of age (p = 0.259) or sex (p = 0.560) between groups. The mean endothelial cell density determined with IVCM was 2124.9 +/- 417.4 cells/mm(2) (1811-3275) in the ocular group and 2546 +/- 335 cells/mm(2) (1798-3280) in the control group (p = 0.000). In the ocular group, the mean density of the subbasal nerve plexus was significantly lower (p = 0.004), and nerve tortuosity was significantly higher (p = 0.002). Conclusions Ocular BD could be responsible for changes in the corneal layers, especially endothelial and corneal nerve structures. Nerve density and tortuosity differences could be inflammatory indicators for BD.