Duration 5min, Q&A 3min
Non-Glaucomatous Focal Retinal Nerve Fiber Layer Defects in Behçet Uveitis
To describe non-glaucomatous retinal nerve fiber layer (RNFL) defects secondary to inner retinal infiltrates and/or focal vasculitis of the optic nerve head in patients with Behçet uveitis.
We reviewed photographic records of 259 Behçet patients and 103 ocular toxoplasmosis patients (control group) and included 76 eyes of 62 patients with Behçet uveitis and 14 eyes of 12 patients with ocular toxoplasmosis manifesting RNFL defects.
Clinical records, visual field analyses, and optical coherence tomography (OCT) scans of the patients with focal RNFL defects were reviewed.
Results and Conclusion
Three forms of RNFL defects were identified in Behçet patients: papillomacular bundle defect (Group 1), central (Group 2) and peripheral (Group 3) temporal slit-like or wedge shaped RNFL defects. Although all patients had bilateral involvement of Behçet uveitis 48 patients revealed unilateral focal RNFL loss. There were 21 eyes (27%) in Group 1, 28 eyes (37%) in Group 2, and 27 eyes (36%) in Group 3. None of the eyes had visible chorioretinal scar. Corollary thinning was detected by OCT and corresponding visual field loss occurred in the absence of central nervous system involvement or glaucoma. In the ocular toxoplasmosis group all slit-like or wedge-shaped RNFL defects were associated with a chorioretinal scar. In conclusion, inner retinal infiltrates at the posterior pole and/or focal vasculitis of the optic nerve head may lead to a focal damage to the ganglion cell layer and RNFL in Behçet uveitis and ocular toxoplasmosis.
[ Keyword ]
Behçet uveitis / Ocular toxoplasmosis / Retinal nerve fiber layer defects
[ Conflict of Interest ]