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Abstract Behcet disease is a very distenctive type of vasculitis of unknown pathogenesis. It’s charactarized muco-cutaneous manifestations with ocular involvement as a magor criteria in its diagnosis. Its signs includes recurrent oral ulcer, recurrent genital ulcers, erythema nodosum and vascular insults such as deep venous thrombosis. The most common ocular presentation of Behcet disease is panuveitis mainly affecting retinal and choroidal vasculature. It has many ocular complications that can affect vision permenantly including retinal vasculitis , scleritis, retinal vasular occlusion and optic neuritis. Historically, steroids were the 1st line of therapy fo Behcet disease. With time non- biologic DMARDs replaced steroid in controling its activity with improving its prognosis. Recently biologic DMARDs including adalimumab have proven to have higher hand in treatment of Behcet disease and controling intraocular inflammation. So, the aim of this study was to assess and compare the optical coherence tomography angiography results between patients on old conventional treatment and those on adalimumab to compare their effects on microvascular changes in retina. This study was a cross-sectional analysis on 90 eyes of Patient of established diagnosis of Behcet disease (30 eyes of patients on adalimumab, 30 eyes of patient conventional treatment, 30 eyes of patients of newly diagnosed Behcet disease as control ) At Minia University Hospital, the study was carried out. The patients were recruited from the rheumatology department. All patients subjected to history taking and full ophthalmological examination before performing OCT-A. OCT-A parameters included vessel density at superficial, deep capillary plexuses and Choriocapillaris in the whole image, fovea and Parafovea and foveal avascular zone area. This study showed that patients on adalimumab therapy had significantly better vision compared to patients on conventional treatment. Our study also demonstrated that Behcet disease patients on conventional treatment had the worst vessel density of deep capillary plexus among three groups. Furthermore, patient receiving conventional treatment in our study had the largest foveal avascular zone area among the 3 groups. The current study found no difference among the 3 groups regarding vessel density of superficial capillary plexus or choriocapillaris. |