OCTA Biomarkers in Sight-Threatening Behcet's Disease-Related Uveitis Treated with Adalimumab

Abstract Background: The use of adalimumab in the treatment of Behcet's disease-related uveitis has been demonstrated to be safe and effective in a recent large retrospective study. This study aimed to evaluate the effectiveness of OCTA in detecting abnormalities in the retinal microvasculature following remis-sion achieved with adalimumab treatment. Aim of Study: To evaluate retinal microvasculature param-eters during Behcet's uveitis (BU) remission status reached post treatment with adalimumab via optical coherence tom-ography angiography (OCTA), and compares the results with those from healthy eyes. Material and Methods: A total of 10 eyes of 10 BU patients presenting during the remission period (within 12 months) of BU involving the posterior segment were enrolled, as were 20 normal eyes of 20 age and sex-matched healthy participants. OCTA images were analyzed. Foveal avascular zone (FAZ), and vessel densities (VD) were calculated and compared. Results: 10 eyes of 10 BU patients and 20 normal eyes of 20 age and sex-matched subjects were included in the study. At baseline, the all 10 eyes had active retinal vasculitis. Retinal vasculitis resolved in all cases (100%) after starting adalimu-mab. The mean time to complete resolution of inflammation was 3.4 weeks. None of the patients developed any adverse events associated with adalimumab treatment. The FAZ was higher in the BD group than in the control group (p=0.01). Both the superficial and deep plexuses vessel densities were significantly lower in BD eyes (p<0.05). Conclusion: BD can cause irreversible damage to the retinal circulation affecting both SCP and DCP. OCTA gives a full view of the retinal microvasculature. Adalimumab was effective in preventing irreversible sight-threatening BD. Adalimumab treatment appears to be associated with improve-ment of the retinal blood flow more evident in the DCP thus provide better final visual outcome for cases with BD uveitis.