Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Oküler Tutulumu Olmayan Behçet Hastalarının Arka Segment Bulgularının Değerlendirilmesi: Kesitsel Araştırma
Evaluation of Posterior Segment Findings in Behçet's Patients Without Ocular Involvement: Cross-Sectional Research
Neşe ARSLANa, Tolga BİÇERa, Naciye KABATAŞa, Cem ÖZİŞLERb
aSağlık Bilimleri Üniversitesi Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Göz Hastalıkları Kliniği, Ankara, Türkiye
bSağlık Bilimleri Üniversitesi Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Romatoloji Kliniği, Ankara, Türkiye
Turkiye Klinikleri J Ophthalmol. 2022;31(3):158-63
doi: 10.5336/ophthal.2021-86265
Article Language: TR
Full Text
ÖZET
 Amaç: Bu çalışmanın amacı, oküler tutulum hikâyesi olmayan Behçet hastalarının iç ve dış retinal katmanların ve koroid kalınlıklarının sağlıklı kişiler ile karşılaştırılmasıdır. Gereç ve Yöntemler: Behçet hastalığı olan, göz tutulumu olmayan 33 hastanın 64 gözü ile 34 kontrolün 68 gözü çalışmaya dâhil edildi. Spektral domain optik koherens tomografi ile arka segment ölçümleri yapıldı. İç retinal ve dış retinal tabaka kalınlıkları foveal, parafoveal ve perifoveal bölgede temporal, nazal, superior ve inferior olmak üzere toplam 9, koroid kalınlıkları foveal, nazal ve temporal yönlerde parafoveal ve perifoveal olmak üzere 5 noktadan ölçüldü. Ortalama retina sinir lifi tabakası (RSLT) ve ganglion hücre kompleksi (GHK) kalınlıkları ölçüldü ve sonuçlar gruplar arasında karşılaştırıldı. Bulgular: Hastaların ortalama tanı süresi 11,54±7,2 yıl idi. Hasta ve kontrol grupları arasında yaş ortalamaları ve kadın-erkek oranı açısından anlamlı bir fark bulunmadı (p>0,05). İç retina tabakasında fovea ve temporal parafoveal hariç, dış retina tabakasında ise nazal parafoveal, superior parafoveal ve inferior parafoveal segmentler hariç tum segmentlerde anlaml ̈ ı incelme görüldü (p0,05). Sonuç: Çalışmamızda retina iç ve dış katmanlarında, RSLT ve GHK ölçumlerinde incelme görülürken koroid kal ̈ ınlığının etkilenmediği saptanmıştır. Bu bulgulara göre göz tutulumu olmayan Behçet hastalarında, RSLT ve GHK kalınlıklarının koroide göre daha erken dönemde etkilendiği düşünülmektedir.

Anahtar Kelimeler: Behçet hastalığı; ganglion hücre kompleksi; koroid; retina; retina sinir lifi tabakası
ABSTRACT
 Objective: Comparison of inner and outer retinal layers and choroidal thicknesses of Behçet's patients without a history of ocular involvement with healthy individuals. Material and Methods: Sixty four eyes of 33 patients with Behçet's disease without ocular involvement and 68 eyes of 34 controls were included in the study. Posterior segment measurements were made with spectral domain-optical coherence tomography. Inner retinal and outer retinal layer thicknesses were measured from a total of 9 points in the foveal, parafoveal and perifoveal regions as temporal, nasal, superior and inferior, and choroidal thicknesses were measured from 5 points in the foveal, nasal and temporal directions as parafoveal and perifoveal. Mean retina nerve fibre layer (RNFL) and ganglion cell complex (GCC) thicknesses were measured and results were compared between groups. Results: The mean duration of diagnosis of the patients was 11.54±7.2 years. There was no significant difference between the patient and control groups in terms of mean age and male-female ratio (p>0.05). Significant thinning was observed in all segments except the fovea and temporal parafoveal in the inner retinal layer, and in all segments except the nasal parafoveal, superior parafoveal and inferior parafoveal segments in the outer retinal layer (p0.05). Conclusion: In our study, thinning was observed in the inner and outer retinal layers, RNFL and GCC measurements, while choroidal thickness was not affected. According to these findings, it is thought that RNFL and GCC thicknesses are affected earlier than the choroid in Behçet's patients without ocular involvement.

Keywords: Behçet disease; ganlion cell complex; choroid; retina; retina nerve fiber layer
REFERENCES:
  1. Azizlerli G, Köse AA, Sarica R, Gül A, Tutkun IT, Kulaç M, et al. Prevalence of Behçet's disease in Istanbul, Turkey. Int J Dermatol. 2003;42(10):803-6. [Crossref]  [PubMed] 
  2. Tugal-Tutkun I, Onal S, Altan-Yaycioglu R, Huseyin Altunbas H, Urgancioglu M. Uveitis in Behçet disease: an analysis of 880 patients. Am J Ophthalmol. 2004;138(3):373-80. [Crossref]  [PubMed] 
  3. Ozdal PC, Ortaç S, Taşkintuna I, Firat E. Posterior segment involvement in ocular Behçet's disease. Eur J Ophthalmol. 2002;12(5):424-31. [Crossref]  [PubMed] 
  4. International Team for the Revision of the International Criteria for Behçet's Disease (ITR-ICBD). The International Criteria for Behçet's Disease (ICBD): a collaborative study of 27 countries on the sensitivity and specificity of the new criteria. J Eur Acad Dermatol Venereol. 2014;28(3):338-47. [Crossref]  [PubMed] 
  5. Atmaca LS, Sonmez PA. Fluorescein and indocyanine green angiography findings in Behçet's disease. Br J Ophthalmol. 2003;87(12):1466-8. [Crossref]  [PubMed]  [PMC] 
  6. Kim M, Kim H, Kwon HJ, Kim SS, Koh HJ, Lee SC. Choroidal thickness in Behcet's uveitis: an enhanced depth imaging-optical coherence tomography and its association with angiographic changes. Invest Ophthalmol Vis Sci. 2013;54(9):6033-9. [Crossref]  [PubMed] 
  7. Coskun E, Gurler B, Pehlivan Y, Kisacik B, Okumus S, Yayuspayı R, et al. Enhanced depth imaging optical coherence tomography findings in Behçet disease. Ocul Immunol Inflamm. 2013;21(6):440-5. [Crossref]  [PubMed] 
  8. Karadag AS, Bilgin B, Soylu MB. Comparison of optical coherence tomographic findings between Behcet disease patients with and without ocular involvement and healthy subjects. Arq Bras Oftalmol. 2017;80(2):69-73. [Crossref]  [PubMed] 
  9. Mishima S, Masuda K, Izawa Y, Mochizuki M, Namba K. The eighth Frederick H. Verhoeff Lecture. presented by saiichi mishima, MD Behçet's disease in Japan: ophthalmologic aspects. Trans Am Ophthalmol Soc. 1979;77:225-79. [PubMed]  [PMC] 
  10. Sibley C, Yazici Y, Tascilar K, Khan N, Bata Y, Yazici H, et al. Behçet syndrome manifestations and activity in the United States versus Turkey -- a cross-sectional cohort comparison. J Rheumatol. 2014;41(7):1379-84. [Crossref]  [PubMed]  [PMC] 
  11. Burton-Kee JE, Mowbray JF, Lehner T. Different cross-reacting circulating immune complexes in Behçet's syndrome and recurrent oral ulcers. J Lab Clin Med. 1981;97(4):559-67. [PubMed] 
  12. Turkcuoglu P. Behçet hastalığı ve retinal vaskülitler [Behcet's disease and retinal vasculitis]. Ret-Vit. 2012;20:130-5. [Link] 
  13. Yang P, Fang W, Meng Q, Ren Y, Xing L, Kijlstra A. Clinical features of chinese patients with Behçet's disease. Ophthalmology. 2008;115(2):312-8.e4. [Crossref]  [PubMed] 
  14. Markomichelakis NN, Halkiadakis I, Pantelia E, Peponis V, Patelis A, Theodossiadis P, et al. Patterns of macular edema in patients with uveitis: qualitative and quantitative assessment using optical coherence tomography. Ophthalmology. 2004;111(5):946-53. [Crossref]  [PubMed] 
  15. Ataş M, Yuvacı I, Demircan S, Güler E, Altunel O, Pangal E, et al. Evaluation of the macular, peripapillary nerve fiber layer and choroid thickness changes in Behçet's disease with spectral-domain OCT. J Ophthalmol. 2014;2014:865394. [Crossref]  [PubMed]  [PMC] 
  16. Cheng D, Wang Y, Huang S, Wu Q, Chen Q, Shen M, et al. Macular inner retinal layer thickening and outer retinal layer damage correlate with visual acuity during remission in Behcet's disease. Invest Ophthalmol Vis Sci. 2016;57(13):5470-8. [Crossref]  [PubMed] 
  17. Yamamoto M, Nishijima K, Nakamura M, Yoshimura N. Inner retinal changes in acute-phase Vogt-Koyanagi-Harada disease measured by enhanced spectral domain optical coherence tomography. Jpn J Ophthalmol. 2011;55(1):1-6. [Crossref]  [PubMed] 
  18. Forooghian F, Yeh S, Faia LJ, Nussenblatt RB. Uveitic foveal atrophy: clinical features and associations. Arch Ophthalmol. 2009;127(2):179-86. [Crossref]  [PubMed]  [PMC] 
  19. Tran TH, de Smet MD, Bodaghi B, Fardeau C, Cassoux N, Lehoang P. Uveitic macular oedema: correlation between optical coherence tomography patterns with visual acuity and fluorescein angiography. Br J Ophthalmol. 2008;92(7):922-7. [Crossref]  [PubMed] 
  20. Paovic J, Paovic P, Sredovic V. Behcet's disease: systemic and ocular manifestations. Biomed Res Int. 2013;2013:247345. [Crossref]  [PubMed]  [PMC] 
  21. Oray M, Onal S, Bayraktar S, Izgi B, Tugal-Tutkun I. Nonglaucomatous localized retinal nerve fiber layer defects in Behçet uveitis. Am J Ophthalmol. 2015;159(3):475-81.e1. [Crossref]  [PubMed] 
  22. Ucar D, Uygunoglu U, Dikkaya F, Yıldırım Y, Yuksel-Elgin C, Saip S, et al. Retinal nerve fiber layer structure abnormalities in patients with Neuro-Behcet's disease. Graefes Arch Clin Exp Ophthalmol. 2015;253(7):1181-5. [Crossref]  [PubMed] 
  23. Onal S, Uludag G, Oray M, Mengi E, Herbort CP, Akman M, et al. Quantitative analysis of structural alterations in the choroid of patients with active Behçet Uveitis. Retina. 2018;38(4):828-40. [Crossref]  [PubMed] 
  24. Chung YR, Cho EH, Jang S, Lee SY, Lee ES, Lee K. Choroidal thickness indicates subclinical ocular and systemic inflammation in eyes with Behçet disease without active inflammation. Korean J Ophthalmol. 2018;32(4):290-5. [Crossref]  [PubMed]  [PMC] 
  25. Mittal A, Velaga SB, Falavarjani KG, Nittala MG, Sadda SR. Choroidal thickness in non-ocular Behçet's disease - A spectral-domain OCT study. J Curr Ophthalmol. 2017;29(3):210-3. [Crossref]  [PubMed]  [PMC] 
  26. Kitaichi N, Miyazaki A, Iwata D, Ohno S, Stanford MR, Chams H. Ocular features of Behcet's disease: an international collaborative study. Br J Ophthalmol. 2007;91(12):1579-82. [Crossref]  [PubMed]  [PMC] 

.: Up To Date

.: Process List

Login

 Forgot your password?

 New Registration  

Contact

Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com