Optical coherence tomography angiography of subclinical ocular features in pediatric Behcet disease

PURPOSE To investigate macular and optic nerve head (ONH) vascular density (VD), foveal avascular zone (FAZ) area, choroidal thickness, outer retina and choriocapillaris flow, and morphological changes of foveal microvasculature in pediatric Bel wet disease (BD) without ocular involvement using optical coherence tomography angiography (OCTA). METHODS We analyzed 22 eyes of 22 pediatric patients diagnosed with BD without ocular involvement and 24 age- and sex-matched healthy controls in this prospective, cross-sectional study. The superficial capillary plexus (SCP) and the deep capillary plexus (DCP), FAZ parameters, the flow area of the outer retina, and choriocapillaris were evaluated using OCTA. RESULTS Vessel density of the whole image, fovea, parafovea, and perifovea in DCP were significantly lower in the nonocular pediatric BD group (P = 0.008, P = 0.038, P = 0.046, and P = 0.008, resp.). There was no significant difference between the groups in VD parameters of both SCP and ONH, as well as FAZ parameters (P > 0.05 for all). Although outer retina and choriocapillaris flow area at 1 mm, 2 mm, and 3 mm radius were lower in the nonocular pediatric BD group than in the control group, the difference was statistically significant only in the outer retina flow area at 3 mm radius (P = 0.011). CONCLUSIONS In this cohort of pediatric nonocular BD patients, there was decreased vessel density in the DCP and decreased outer retinal flow. Hence, OCTA can reveal microvascular changes in patients without detectable ocular involvement.