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Gökgöz Özışık G, Eker Buyuksireci D, Şahin T, Caglıyan Turk A. Evaluation of Choroidal Thickness and Choroidal Vascularity Index in Patients with Rheumatoid Arthritis. Ocul Immunol Inflamm 2024:1-8. [PMID: 38691844 DOI: 10.1080/09273948.2024.2345289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 04/16/2024] [Indexed: 05/03/2024]
Abstract
PURPOSE To evaluate the choroidal vascularity index and choroidal thickness in patients with rheumatoid arthritis. METHOD This study is a case control study. Our study consists of a total of two groups, with 32 individuals diagnosed with rheumatoid arthritis (RA) and 32 healthy volunteers. The thickness of the subfoveal choroid was measured from the 500 micron (µm), 1000 µm, 1500 µm nasal aspect of the fovea, and 500µm, 1000µm, 1500 µm temporal and subfoveal thickness of the fovea. ImageJ version 1.53i (National Institutes of Health, Bethesda, MD, USA) from open access was used for choroidal vascular index calculation. RESULTS The mean age (p = 0.064) and gender distribution (p = 0.522) were not statistically different between these two groups. There was no difference between the groups in terms of visual acuity (p = 0.060), intraocular pressures (p=0.056), refractive errors (p = 0.418), and axial lengths (p = 0.280). Temporal 500 µm CT (p = 0.038), temporal 1000 µm CT (p = 0.010), and temporal 1500 µm CT (p = 0.005) differed significantly between the groups. The luminal area was significantly different between the RA group (842.71 ± 192.77) and the control group (957.78 ± 230.83) (p = 0.034). The choroidal vascularity index showed a significant difference between the RA group (64.99 ± 4.71) and the control group (67.34 ± 3.40) (p = 0.026). A significant difference was observed between the seronegative RA and the control group with temporal 1500 µm CT (p = 0.030), temporal 1000 µm CT (p = 0.023), and luminal area (p = 0.034). CONCLUSION We demonstrated thinning in CT and decreased CVI for the first time in RA patients by comparing it with the control group.
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Affiliation(s)
- Gülce Gökgöz Özışık
- Department of Ophthalmology, Faculty of Medicine, Hitit University, Corum, Turkey
| | - Dilek Eker Buyuksireci
- Department of Physical Therapy and Rehabilitation, Faculty of Medicine, Hitit University, Corum, Turkey
| | - Tayfun Şahin
- Department of Ophthalmology, Faculty of Medicine, Hitit University, Corum, Turkey
| | - Ayla Caglıyan Turk
- Department of Physical Therapy and Rehabilitation, Faculty of Medicine, Hitit University, Corum, Turkey
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Fekrazad S, Shahrabi Farahani M, Salehi MA, Hassanzadeh G, Arevalo JF. Choroidal thickness in eyes of rheumatoid arthritis patients measured using optical coherence tomography: A systematic review and meta-analysis. Surv Ophthalmol 2024; 69:435-440. [PMID: 38307210 DOI: 10.1016/j.survophthal.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 01/23/2024] [Accepted: 01/29/2024] [Indexed: 02/04/2024]
Abstract
Rheumatoid arthritis (RA), an autoimmune disease, affects eyes in 25% of cases. Retinal alterations in RA can function as biomarkers as early risk indicators for developing sight-threatening conditions. Optical coherence tomography (OCT) provides high-resolution images of the retina and its component's thickness measures. The purpose of this review is to compare the choroidal thickness (CT) of RA patients and healthy controls. We examined the databases of PubMed, Scopus, and Embase. Depending on the heterogeneity, an appropriate model was used for the meta-analysis. Additionally, meta-regression, publication bias, subgroup analyses, and quality evaluation were carried out. We evaluated 8 studies involving 363 RA patients and 343 healthy controls. Our findings demonstrated that RA participants had significantly lower CT at 500 and 1500 µm nasal and temporal to the fovea compared to controls. The subfoveal, 1000 µm temporal and nasal to the fovea, and average CT, however, did not demonstrate statistical significance. The results of this study demonstrate that choroidal thickness is different in RA patients from healthy controls in several areas. OCT measurements may be related to both the visual acuity and the possibility of developing several rheumatic-ophthalmic problems. Future research is thus needed to get more firm findings.
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Affiliation(s)
- Sepehr Fekrazad
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; International Network for Photomedicine and Photodynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | | | | | | | - J Fernando Arevalo
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Manfredini M, Ragusa E, Gibertini M, Bigi L, Ferrari B, Lasagni C, Magnoni C, Lazzerini A, Farnetani F, Verdina T. Retinal Microvascular Alterations in Hidradenitis Suppurativa Patients: A Pilot Study Using Optical Coherence Tomography Angiography. J Clin Med 2024; 13:1464. [PMID: 38592296 PMCID: PMC10932047 DOI: 10.3390/jcm13051464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/07/2024] [Accepted: 02/28/2024] [Indexed: 04/10/2024] Open
Abstract
Background: Hidradenitis suppurativa (HS) is a relapsing-remitting inflammatory disease characterized by the progression of asymptomatic nodules to deep-seated lesions and fistula formation that leads to suppuration and scarring. Optical coherence tomography angiography (OCTA) is a new non-invasive imaging technique that carefully analyzes retinal microvasculature networks with high-resolution imaging. Recent studies have demonstrated that retinal vessel density and retinal perfusion reflect systemic inflammatory responses. This study's aim was to analyze OCTA-derived retinal microvasculature parameters to understand if patients affected by HS and without any relevant ocular or systemic comorbidities showed impaired retinal vascular function and morphology. Method: We performed a case-control study of HS patients and age- and sex-matched control cohort. A total of 20 eyes from 10 HS patients and 30 eyes from 15 healthy controls were analyzed, and OCTA-derived microvasculature parameters were compared between groups. Results: OCTA images showed that HS patients, compared to healthy controls, were typically characterized by higher values of the foveal avascular zone (FAZ) both in the superficial capillary plexus (SCP) and in the deep capillary plexus (DCP), and by lower values of vessel density (VD)-SCP, VD-DCP, and vessel length density (VLD)-SCP in the foveal region. These findings partially reflect changes that have been demonstrated in diabetic patients that could be induced by a protracted metabolic or systemic inflammatory dysregulation. Conclusions: In conclusion, OCTA enables large-scale, non-invasive visual screening and follow-up of the retinal vasculature features, providing a new strategy for the prevention and monitoring of visual changes in HS patients.
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Affiliation(s)
- Marco Manfredini
- Dermatology Unit, Department of Surgical, Medical, Dental & Morphological Sciences with Interest Transplant, Oncological & Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy (C.L.)
| | - Emanuele Ragusa
- Institute of Ophthalmology, Department of Surgical, Medical, Dental & Morphological Sciences with Interest Transplant, Oncological & Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Matteo Gibertini
- Institute of Ophthalmology, Department of Surgical, Medical, Dental & Morphological Sciences with Interest Transplant, Oncological & Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Laura Bigi
- Dermatology Unit, Department of Surgical, Medical, Dental & Morphological Sciences with Interest Transplant, Oncological & Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy (C.L.)
| | - Barbara Ferrari
- Dermatology Unit, Department of Surgical, Medical, Dental & Morphological Sciences with Interest Transplant, Oncological & Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy (C.L.)
| | - Claudia Lasagni
- Dermatology Unit, Department of Surgical, Medical, Dental & Morphological Sciences with Interest Transplant, Oncological & Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy (C.L.)
| | - Cristina Magnoni
- Dermatology Unit, Department of Surgical, Medical, Dental & Morphological Sciences with Interest Transplant, Oncological & Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy (C.L.)
| | - Andrea Lazzerini
- Institute of Ophthalmology, Department of Surgical, Medical, Dental & Morphological Sciences with Interest Transplant, Oncological & Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Francesca Farnetani
- Dermatology Unit, Department of Surgical, Medical, Dental & Morphological Sciences with Interest Transplant, Oncological & Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy (C.L.)
| | - Tommaso Verdina
- Institute of Ophthalmology, Department of Surgical, Medical, Dental & Morphological Sciences with Interest Transplant, Oncological & Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy
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Kaymaz S, Savurmuş N, Karasu U, Kaya H, Ufuk F, Rüksan Ütebey A, Çobankara V, Yiğit M. Association between choroidal thickness and interstitial lung disease in patients with rheumatoid arthritis: A cross-sectional study. Arch Rheumatol 2024; 39:89-98. [PMID: 38774707 PMCID: PMC11104761 DOI: 10.46497/archrheumatol.2023.10116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/22/2023] [Indexed: 05/24/2024] Open
Abstract
Objectives This study aimed to evaluate choroidal thickness (CT) in patients with rheumatoid arthritis (RA) and healthy controls and to determine its relationship with RA-associated interstitial lung disease (RA-ILD). Patients and methods A total of 63 patients with RA and 36 age- and sex-matched healthy controls were recruited in the cross-sectional study. Serological findings, Disease Activity Score-28, disease duration, and medical treatment of patients were recorded. Patients with RA were subdivided into two groups: patients with RA-ILD (Group 1) and patients with RA but without ILD (RA-noILD; Group 2). CTs were measured using enhanced depth imaging optical coherence tomography. CT was measured at five points: the subfoveal region, 750 μm nasal and temporal to the fovea, 1500 μm nasal and temporal to the fovea. Patients with RA-ILD were evaluated with delta high-resolution computed tomography (ΔHRCT) and pulmonary function test to determine the severity of interstitial lung disease. Results Four of 63 RA patients were excluded due to comorbidities. Thus, 59 RA patients, 20 in the RA-ILD group and 39 in the RA-noILD group, were included in the analyses. The RA groups were similar in terms of clinical characteristics and laboratory findings. There were statistically significant differences between Group 1, Group 2 and healthy controls (Group 3) compared to all CT values (p<0.05). The mean CT measured at 750 μm and 1500 μm nasal to the fovea was lowest in the RA-ILD group, followed by the RA-noILD and healthy groups (p<0.05). CT measurements did not correlate with the pulmonary function test and ΔHRCT. Conclusion RA-ILD patients had a thinner CT measured at nasal points. However, there was no association between CT measurements and the severity of ILD.
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Affiliation(s)
- Serdar Kaymaz
- Department of Internal Medicine, Division of Rheumatology, Pamukkale University Faculty of Medicine, Denizli, Türkiye
| | - Nilüfer Savurmuş
- Department of Chest Disease and Pulmonology, Pamukkale University Faculty of Medicine, Denizli, Türkiye
| | - Uğur Karasu
- Department of Internal Medicine, Division of Rheumatology, Pamukkale University Faculty of Medicine, Denizli, Türkiye
| | - Hüseyin Kaya
- Department of Opthalmology, Pamukkale University Faculty of Medicine, Denizli, Türkiye
| | - Furkan Ufuk
- Department of Radiology, Pamukkale University Faculty of Medicine, Denizli, Türkiye
| | - Ayşe Rüksan Ütebey
- Department of Radiology, Pamukkale University Faculty of Medicine, Denizli, Türkiye
| | - Veli Çobankara
- Department of Internal Medicine, Division of Rheumatology, Pamukkale University Faculty of Medicine, Denizli, Türkiye
| | - Murat Yiğit
- Department of Internal Medicine, Division of Rheumatology, Pamukkale University Faculty of Medicine, Denizli, Türkiye
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Kiyat P, Karti O, Gercik Ö, Şak T. Choroidal, retinal, and optic nerve changes in rheumatoid arthritis and primary sjogren's syndrome patients: comparıson with each other and healthy subjects. Int Ophthalmol 2024; 44:24. [PMID: 38324105 DOI: 10.1007/s10792-024-02970-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 12/04/2023] [Indexed: 02/08/2024]
Abstract
PURPOSE The present study aims to evaluate the optic nerve, macula, and choroidal changes in both rheumatoid arthritis (RA) and primary Sjögren's syndrome (SjS) patients, and to compare these findings with age-matched healthy volunteers. METHODS This study included 46 RA patients, 33 primary SjS patients, and 37 age-matched healthy volunteers. All of the patients underwent a thorough ophthalmological examination, during which measurements of the retinal nerve fiber layer (RNFL), ganglion cell layer(GCL), and subfoveal choroidal thickness (CT) were taken using OCT (optical coherence tomography). The measurements taken from the right eye of each patient were used to compare among the groups. RESULTS RNFL thickness in superior quadrant was found to be statistically significantly thinner in the eyes with RA when compared to the control group (p = 0.022). In the nasal quadrant, the RNFL thickness was significantly thinner in patients with primary SjS compared to healthy individuals (p = 0.036). Also, the temporal quadrant RNFL was significantly thinner in RA patients than in the primary SjS patients (p = 0.033). GCL thickness was observed to be thinner in all quadrants of both RA and primary SjS groups compared to the control group. However, the difference was not found to be statistically significant. Subfoveal CT was observed to be thicker in RA and SjS groups compared to the control group, but this difference was also not statistically significant. CONCLUSION Systemic autoimmune diseases like RA and primary SjS can lead to a decrease in RNLF and GCL thickness, which can impair visual acuity even in the absence of ocular symptoms. Therefore, monitoring changes in the optic nerve, retina, and choroid layer are crucial in these patients.
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Affiliation(s)
- Pelin Kiyat
- Department of Ophthalmology, İzmir Democracy University, Buca Seyfi Demirsoy Training and Research Hospital, Kozağaç Mah., Özmen Sok., No:147, Buca, İzmir, Turkey.
| | - Omer Karti
- Department of Ophthalmology, İzmir Democracy University, Buca Seyfi Demirsoy Training and Research Hospital, Kozağaç Mah., Özmen Sok., No:147, Buca, İzmir, Turkey
| | - Önay Gercik
- Department of Rheumatology, İzmir Democracy University, Buca Seyfi Demirsoy Training and Research Hospital, İzmir, Turkey
| | - Tuncer Şak
- Department of Rheumatology, İzmir Democracy University, Buca Seyfi Demirsoy Training and Research Hospital, İzmir, Turkey
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Hasan N, Driban M, Mohammed AR, Schwarz S, Yoosuf S, Barthelmes D, Vupparaboina KK, Al-Sheikh M, Chhablani J. Effects of hydroxychloroquine therapy on choroidal volume and choroidal vascularity index. Eye (Lond) 2024; 38:620-624. [PMID: 37770532 PMCID: PMC10858202 DOI: 10.1038/s41433-023-02747-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 08/09/2023] [Accepted: 09/11/2023] [Indexed: 09/30/2023] Open
Abstract
PURPOSE To determine changes in choroidal volume (CV) and choroidal vascularity index (CVI) in patients on hydroxychloroquine (HCQ) therapy. METHODS Retrospective analysis of patients on HCQ therapy. CV and CVI were assessed below the central foveal region on spectral-domain optical coherence tomography using an automatic denoising and localization algorithm. CV and CVI were compared with age-matched controls. Regression analyses were performed to generate associations between CV and CVI with demographics and HCQ treatment parameters. Associations were assessed using a generalized estimating equation model adjusted for intra-subject inter-eye correlations. RESULTS A total of 137 adult patients (23 males and 114 females) were included. Mean age was 45.6 ± 13.7 years and most patients identified as Caucasian (79%). Total duration of HCQ therapy ranged from 3 months to 20 years. Daily HCQ intake varied from 150-600 mg (mean = 304 mg), while cumulative doses ranged from 18-2,800 g. At presentation, the median CV was 0.51 (IQR:0.356-0.747) mm, and median CVI was 0.559 (IQR:0.528-0.578). Increased cumulative HCQ dose was associated with decreased CV (p = 0.006). Compared to age-matched controls, CV, CVI, and luminal area were significantly lower in the study group (p = 0.0003, 0.0001, and 0.0002). CONCLUSION In this study, we present a novel analysis of key biomarkers which predate the occurrence of HCQ retinopathy. Choroidal volume and vascularity index are significantly reduced in patients on HCQ therapy, especially at higher cumulative doses. These findings suggest new tools to guide medical decision-making for patients receiving HCQ therapy for rheumatologic diseases.
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Affiliation(s)
- Nasiq Hasan
- Dr. Agarwal's Eye Hospital, Tirunelveli, Tamil Nadu, India
| | - Matthew Driban
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Swen Schwarz
- University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Shakira Yoosuf
- Department of Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | | | | - Mayss Al-Sheikh
- University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Jay Chhablani
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
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Lee HY, Chen J, Ying P, Xu SH, Kang M, Zou J, Liao XL, Shi W, Ling Q, Wang YX, Wei H, Shao Y. Investigation of altered retinal microvasculature in female patients with rheumatoid arthritis: optical coherence tomography angiography detection. Biosci Rep 2023; 43:BSR20230045. [PMID: 37665319 PMCID: PMC10578346 DOI: 10.1042/bsr20230045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 06/01/2023] [Accepted: 06/27/2023] [Indexed: 09/05/2023] Open
Abstract
BACKGROUND Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disorder that primarily causes symmetrical polyarthritis and bone deformity. In RA patients, sight-threatening inflammatory eye complications would be expected. OBJECTIVE The objective of the study is to ascertain the macular retinal vessel density changes in RA patients and controls using optical coherence tomography angiography (OCTA), and to investigate the association between disease and microvascular density alterations. METHODS A total of 12 RA patients (24 eyes) and 12 age- and gender-matched control participants (24 eyes) were recruited to the study. We used the Early Treatment Diabetic Retinopathy Study partitioning, hemispheric quadrants and annular partitioning to segment each image into different subregions. The vascular density of superficial retina layer, deep retina layer and conjunctival capillary plexus was quantitatively measured by OCTA and compared with the control group. Correlation analysis was used to explore the relationship between STMI and conjunctival capillaries densities. RESULTS In the superficial retinal layer, the vascular density of S, I, L, SL, SR, IL and C1-C5 were significantly decreased in the RA group compared with the control group (P<0.05). For the deep retinal layer, the vascular density of S, SL, SR, IL, C1, C2 and C4 also decreased in RA group. A significant positive correlation was indicated between conjunctival vascular and STMI densities (r = 0.713, P<0.05). CONCLUSION OCTA results suggest that RA patients present with a reduced macular retinal vascular density. These subtle alterations of ocular microcirculation may precede severe eye involvements and may be a potential biomarker for early distinguishing abnormal eyes from healthy eyes.
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Affiliation(s)
- Hsuan-Yi Lee
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Branch of National Clinical Research Center for Ocular Disease, Nanchang, Jiangxi 330006, China
- Department of Optometric Medicine and Ophthalmology, The Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Jun Chen
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Branch of National Clinical Research Center for Ocular Disease, Nanchang, Jiangxi 330006, China
| | - Pin Ying
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Branch of National Clinical Research Center for Ocular Disease, Nanchang, Jiangxi 330006, China
| | - San-Hua Xu
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Branch of National Clinical Research Center for Ocular Disease, Nanchang, Jiangxi 330006, China
| | - Min Kang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Branch of National Clinical Research Center for Ocular Disease, Nanchang, Jiangxi 330006, China
| | - Jie Zou
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Branch of National Clinical Research Center for Ocular Disease, Nanchang, Jiangxi 330006, China
| | - Xu-Lin Liao
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong 999077, China
| | - Wenqing Shi
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Branch of National Clinical Research Center for Ocular Disease, Nanchang, Jiangxi 330006, China
| | - Qian Ling
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Branch of National Clinical Research Center for Ocular Disease, Nanchang, Jiangxi 330006, China
| | - Yi-Xin Wang
- School of Optometry and Vision Science, Cardiff University, Cardiff, CF24 4HQ, Wales
| | - Hong Wei
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Branch of National Clinical Research Center for Ocular Disease, Nanchang, Jiangxi 330006, China
| | - Yi Shao
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Branch of National Clinical Research Center for Ocular Disease, Nanchang, Jiangxi 330006, China
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Bilgin B, Sahin Y. Impact of adherence to gluten-free diet in paediatric celiac patients on optical coherence tomography findings: Ocular imaging based study. Photodiagnosis Photodyn Ther 2023; 42:103502. [PMID: 36907258 DOI: 10.1016/j.pdpdt.2023.103502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/22/2023] [Accepted: 03/07/2023] [Indexed: 03/12/2023]
Abstract
OBJECTIVE This study aims to measure choroidal thickness, retinal nerve fiber layer thickness, GCC thickness, and foveal thickness by optical coherence tomography and to investigate whether there is a difference between celiac patients who adhere to the gluten-free diet and who do not. MATERIALS AND METHODS A total of 68 eyes of 34 pediatric patients diagnosed with celiac disease were included in the study. Celiac patients were divided into two groups those who adhere to the gluten-free diet and those who do not. Fourteen patients who adhere to the gluten-free diet and 20 patients who do not adhere to the gluten-free diet were included in the study. Choroidal thickness, GCC, RNFL, and foveal thickness of all subjects were measured and recorded using an optical coherence tomography device. RESULTS The mean choroidal thickness of the dieting and non-diet groups was 249.05 ± 25.60 and 244.18 ± 33.50 µm, respectively. The mean GCC thickness of the dieting and non-diet groups was 96.56 ± 6.26 and 93.83 ± 5.62 µm, respectively. The mean RNFL thickness of the dieting and non-diet groups was 108.83 ± 9.97 and 103.20 ± 9.74 µm, respectively. The mean foveal thickness of the dieting and non-diet groups was 259.25 ± 33.60 and 261.92 ± 32.94 µm, respectively. There was not a statistically significant difference between the dieting group and the non-diet group in terms of choroidal, GCC, RNFL and foveal thicknesses (p = 0.635, p = 0.207, p = 0.117, p = 0.820, respectively). CONCLUSION In conclusion, the present study states that adhering to a gluten-free diet does not make any difference in choroidal, GCC, RNFL, and foveal thicknesses in pediatric celiac patients.
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Affiliation(s)
- Burak Bilgin
- Kahramanmaras Sutcu Imam University, School of Medicine, Department of Ophthalmology, Kahramanmaras, Turkey.
| | - Yasin Sahin
- Gaziantep Islam Science and Technology University, Medical Faculty, Department of Pediatric Gastroenterology, Dr. Ersin Arslan Training and Research Hosptial, Clinics of Pediatric Gastroenterology, Gaziantep, Turkey
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Yeter V, Koçak N, Subaşı M, Parlak U. Choroidal vascularity index in thyroid-associated ophthalmopathy. CANADIAN JOURNAL OF OPHTHALMOLOGY 2023; 58:27-33. [PMID: 34324874 DOI: 10.1016/j.jcjo.2021.06.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 05/15/2021] [Accepted: 06/28/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To investigate the choroidal vascularity index (CVI) in patients with thyroid-associated ophthalmopathy (TAO) and its relationship with clinical features and clinical activity score METHODS: Right eyes of 53 patients with TAO and 53 healthy subjects were scanned for subfoveal choroidal thickness (SFCT), CVI, choroid-stromal area (C-SA), choroid-luminal area (C-LA), choroidal stromal index (CSI), choroid-stromal-to-luminal-area ratio, and CVI and CSI within the central 1500 µm of the macula (CVI1500 and CSI1500) by enhanced-depth imaging optical coherence tomography. The results of the TAO group and the healthy controls were compared. RESULTS The SFCT was significantly greater in the TAO group than in the control group (p = 0.02). The values of C-LA, C-SA, and total choroidal area (TCA) in the TAO group were significantly higher than those in the control group (p = 0.01, p = 0.04, and p = 0.01, respectively). The increases in SFCT, C-LA, C-SA, and TCA were 12.1%, 12.2%, 16.2%, and 13.6%, respectively. There was no statistically significant difference between the groups for CVI, CSI, CVI1500, CSI1500, and choroid-stromal-to-luminal-area ratio (p > 0.05). CVI1500 and CSI1500 have displayed a statistically significant correlation with exophthalmometry and clinical activity score (p < 0.05). CONCLUSION The alterations in stromal and vascular structures are proportionally similar in TAO; thus CVI may not be affected significantly. However, CVI1500 and CSI1500 may be associated with disease activity. The choroidal thickening in TAO may be the result not only of vascular mechanisms but also by an increase in stromal contents.
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Affiliation(s)
- Volkan Yeter
- Department of Ophthalmology, Ondokuz Mayıs University, Samsun, Turkey.
| | - Nurullah Koçak
- Department of Ophthalmology, Ondokuz Mayıs University, Samsun, Turkey
| | - Mustafa Subaşı
- Department of Ophthalmology, Ondokuz Mayıs University, Samsun, Turkey
| | - Utku Parlak
- Department of Ophthalmology, Ondokuz Mayıs University, Samsun, Turkey
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Tufek M, Nalcacioglu P, Capraz M, Varol K, Kaya AT, Aydın N, Kara C. The impact of obesity on ocular hemodynamics and choroidal thickness. Ther Adv Ophthalmol 2023; 15:25158414231180985. [PMID: 37441618 PMCID: PMC10333989 DOI: 10.1177/25158414231180985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 05/22/2023] [Indexed: 07/15/2023] Open
Abstract
Background Obesity affects microvascular structures. The effect of obesity on the ocular vascular system can be evaluated by changes in the choroidal thickness (CT) and retrobulbar blood flow (RBF). Objectives To evaluate the CT and RBF parameters in obese patients with various body mass index (BMI) values and compare these parameters with normal weight, healthy subjects. Design A prospective study. Methods The study included 102 eyes of 102 female patients. Patients were divided into three groups according to BMI as group 1 with a BMI of 18.5-24.99 (n = 32), normal weight group; group 2 with a BMI of 30-34.99 (n = 35), as obese class I; and group 3 with a BMI of 35-39.99 (n = 35), as obese class II. The peak systolic velocity (PSV), end-diastolic velocity (EDV), resistive index, and pulsatility index values of the central retinal artery (CRA) and ophthalmic artery (OA) were evaluated with color Doppler ultrasonography. CT was measured at the subfoveal area and at 500-µm intervals nasal and temporal to the fovea up to a distance of 1500 µm by using the enhanced depth imaging technique of optical coherence tomography. Intraocular pressure (IOP) was measured with a Goldmann applanation tonometry. Results There was a significant difference in IOP values within the groups with the highest values in group 3 (17.6 ± 2.1 mmHg) and the lowest in group 1 (12.4 ± 1.7 mmHg). The CT in groups 2 and 3 was found to be statistically significantly lower than that in group 1 at all measurement points (p < 0.001). There was a statistically significant negative correlation between CT at all measurement points and BMI (p < 0.001). The mean CRA PSV, EDV, and OA EDV values were statistically significantly lower in each obese group than those values in group 1 (p < 0.001). The OA PSV values were significantly lower in group 3 (36.5 ± 5.9 cm/s) than those in group 2 (43.8 ± 4 cm/s) and group 1 (44.6 ± 5.2 cm/s) (p < 0.001). Also, significant associations were found between BMI and CRA PSV, CRA EDV, and OA PSV values (p < 0.001). Conclusion Obesity may predispose to eye pathologies by changing the ocular vascular circulation.
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Affiliation(s)
| | - Pinar Nalcacioglu
- Department of Ophthalmology, Yildirim Beyazit
University Medical School, Ankara, Turkey
| | - Mustafa Capraz
- Department of Internal Medicine, Amasya
University, Sabuncuoglu Serafeddin Training and Research Hospital, Amasya,
Turkey
| | - Kenan Varol
- Department of Radiology, Private Rumeli
Hospital, Istanbul, Turkey
| | - Ahmet Turan Kaya
- Department of Radiology, Amasya University,
Sabuncuoglu Serafeddin Training and Research Hospital, Amasya, Turkey
| | - Nihat Aydın
- Department of Ophthalmology, Amasya University,
Sabuncuoglu Serafeddin Training and Research Hospital, Amasya, Turkey
| | - Caner Kara
- Department of Ophthalmology, Zubeyde Hanim
Women’s Education and Research Hospital, Ankara, Turkey
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11
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Kurumoğlu Incekalan T, Celik U, Tolunay O, Naz Şimdivar GH, Alyamaç Sukgen E. Changes in retinal and choroidal capillary dynamics in patients with multisystem inflammatory syndrome in children. Int Ophthalmol 2023; 43:3-12. [PMID: 36036326 PMCID: PMC9421118 DOI: 10.1007/s10792-022-02382-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 06/14/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE To evaluate patients with multisystemic inflammatory syndrome in children (MIS-C) associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection using optical coherence tomography angiography (OCTA) during and after resolution of inflammation to investigate the effect of this entity on the retinal and choroidal circulation. METHODS The study included 38 eyes of 19 patients diagnosed as having MIS-C between March 2021 and June 2021. OCTA measurements of choroidal thickness and vessel density in the radial peripapillary capillary plexus (RPCP), superficial capillary plexus (SCP), and deep capillary plexus (DCP) obtained at time of diagnosis and 60 days later were compared. Correlations between C-reactive protein (CRP) levels at diagnosis and retinochoroidal involvement were investigated. RESULTS Compared to post-recovery follow-up examinations, patients with active MIS-C showed foveal avascular zone enlargement (p = 0.031), decreased vessel density in the temporal parafoveal SCP (p = 0.047) and all parafoveal areas of the DCP (p < 0.05 for all), and increased choroidal thickness (p = 0.021). Correlation analysis between CRP levels and OCTA changes during MIS-C revealed significant negative correlations with all parafoveal sectors of the SCP and DCP and a significant positive correlation with CT. CONCLUSION There were especially marked effects on the DCP and choroid in MIS-C patients. Our findings also correlate with CRP levels. The use of optical coherence tomography angiography in patients with multisystemic inflammatory syndrome may have potential future implications for detecting ocular microvascular changes that occur before permanent damage develops. Clinical Trial Registration Number and Date: 77/1340; March 1, 2021.
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Affiliation(s)
- Tuğba Kurumoğlu Incekalan
- Depertmant of Opthalmology, Adana City Training and Research Hospital, University of Health Sciences, Adana, Turkey
| | - Umit Celik
- Pediatric Infectious Diseases, Adana City Training and Research Hospital, University of Health Sciences, Adana, Turkey
| | - Orkun Tolunay
- Pediatric Infectious Diseases, Adana City Training and Research Hospital, University of Health Sciences, Adana, Turkey
| | - Goksu Hande Naz Şimdivar
- Depertmant of Opthalmology, Adana City Training and Research Hospital, University of Health Sciences, Adana, Turkey
| | - Emine Alyamaç Sukgen
- Depertmant of Opthalmology, Adana City Training and Research Hospital, University of Health Sciences, Adana, Turkey
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12
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Özgür A, An İ. Evaluation of choroidal thickness and ocular manifestations in lipoid proteinosis. Int Ophthalmol 2023; 43:239-247. [PMID: 35842887 DOI: 10.1007/s10792-022-02422-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 07/04/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE To assess choroidal thickness in patients with lipoid proteinosis versus healthy subjects using enhanced depth imaging optical coherence tomography. METHODS Twenty eyes of 20 patients and the same number of age and sex-matched healthy individuals were enrolled. Comprehensive ocular examinations including measurement of best-corrected visual acuity, spherical equivalent values of refractive errors, and axial length were performed. Choroidal thickness at three points (subfoveal, 500 µm nasal and temporal regions) were measured automatically using MATLAB software. RESULTS The mean age was 15.68 ± 5.98 years in the patient group and 16.48 ± 5.69 years in the control group. Mean choroidal thickness was statistically significantly thicker at each point in patients with lipoid proteinosis compared to the healthy controls: subfoveal, temporal and nasal choroidal thickness measurements were 425.65 ± 51.42, 380.20 ± 69.66, 334.05 ± 49.98 µm in the study group; 346.15 ± 47.76, 330.15 ± 44.35, 298.95 ± 44.21 µm in the control group, respectively (P < 0.05). CONCLUSION Patients with lipoid proteinosis have thicker choroid compared to control eyes. Hyalin deposition and ensuing potential inflammation in the disease process may explain this finding.
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Affiliation(s)
- Armağan Özgür
- Department of Ophthalmology, Şanlıurfa Training and Research Hospital, Şanlıurfa, Turkey.
| | - İsa An
- Department of Dermatology, Şanlıurfa Training and Research Hospital, Şanlıurfa, Turkey
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13
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Optical Coherence Tomography Analysis of Retinal Layers in Celiac Disease. J Clin Med 2022; 11:jcm11164727. [PMID: 36012966 PMCID: PMC9409633 DOI: 10.3390/jcm11164727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/03/2022] [Accepted: 08/11/2022] [Indexed: 02/07/2023] Open
Abstract
Celiac disease is an immune-mediated, chronic, inflammatory, and systemic illness which could affect the eye. The aim of this study is to look for possible signs of retinal involvement in celiac disease that could be utilized as biomarkers for this disease. Sixty-six patients with celiac disease and sixty-six sex-matched healthy subjects were enrolled in this observational case–control study. A comprehensive ophthalmological evaluation, axial length measurements, and SD-OCT evaluation were performed. The thickness of the retinal layers at the circle centered on the fovea (1 mm in diameter) and the average of the foveal and parafoveal zones at 2 and 3 mm in diameter were evaluated, together with retinal volume and the peripapillary retinal nerve fiber layer (RNFL). Concerning the thicknesses of the retinal layers in each analyzed region, no statistically significant differences were found. The same results were obtained for the total volume. Regarding peripapillary RNFL, the celiac patients showed slightly thicker values than the healthy controls, except for temporal and nasal-inferior quadrants, with no statistically significant differences. All the analyzed parameters were similar for the celiac patients and the healthy individuals. This could be related either to the non-involvement of the retinal layers in celiac disease pathophysiology or to the gluten-free diet effect.
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14
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Ocular changes in nephrotic syndrome patients with preserved renal functions. Photodiagnosis Photodyn Ther 2022; 39:103024. [PMID: 35870774 DOI: 10.1016/j.pdpdt.2022.103024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 07/18/2022] [Accepted: 07/19/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Optical coherence tomography (OCT) measurements of central choroidal thickness (CCT) and retinal thickness have been proposed as inflammatory indicators for a variety of systemic disorders, particularly those with a vascular component. The relationship between nephrotic syndrome (NS) and visual impairment is not clear. The aim of this study was to evaluate the ocular changes in primary NS patients with preserved renal functions. METHODS A total of 60 participants (30 NS patients, 30 healthy control subjects) was recruited in this cross-sectional and comparative study. Retinal and choroidal examinations were performed via the spectral domain OCT. Enhanced depth imaging (EDI) mode of the OCT was used for choroidal analysis. RESULTS Although not statistically significant, CCT was found to be higher in the NS group compared to the control group (p=0.07). Central foveal thickness (CFT) and retinal arteriolar caliber (RAC) values were statistically significantly lower in the patients with nephrotic syndrome, whereas retinal venular caliber (RVC) and choroidal vascularity index (CVI) values were similar in both groups. RAC and RVC were not statistically significantly correlated with CCT or CFT in both groups (p>0.05). CONCLUSION The results of the current study showed a significant difference between the NS group and the control group in terms of some ocular changes (i.e., CFT and RAC). As a result, CCT, CFT and RAC measurements with OCT may be used as a marker of inflammation in NS patients.
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15
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Tufek M, Capraz M, Kaya AT, Aydin N, Nalcacioglu P. Retrobulbar Ocular Blood Flow and Choroidal Vascular Changes in Patients Recovering from COVID-19 Infection. Photodiagnosis Photodyn Ther 2022; 39:102976. [PMID: 35724935 PMCID: PMC9212774 DOI: 10.1016/j.pdpdt.2022.102976] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/28/2022] [Accepted: 06/16/2022] [Indexed: 11/17/2022]
Abstract
Background To evaluate the effects of COVID-19 infection on the ocular vascular structure including choroidal thickness and retrobulbar blood flow values in comparison with healthy subjects. Methods Ninety eyes of 90 patients were included in this study. Participants were divided into Group 1 (n = 30) with mild COVID-19 infection, Group 2 (n = 31) with moderate disease, and Group 3 with age- and sex-matched healthy subjects (n = 29). Choroidal thickness was measured at the subfoveal area and at 500-µm intervals nasal and temporal to the fovea up to a distance of 1500 µm, using the enhanced depth imaging (EDI) technique of spectral coherence tomography (SD-OCT). The peak systolic velocity (PSV), end diastolic velocity (EDV), resistive index (RI), and pulsatility index (PI) values of the central retinal artery (CRA) and ophthalmic artery (OA) were evaluated with color Doppler ultrasonography (CDU). Results The choroidal thickness was significantly thinner in Group 1 and Group 2 than in Group 3 at all measurement points (p <0.001). This difference was not present between Group 1 and Group 2 who had COVID-19 disease of different severity (p>0.05).Among the retrobulbar blood flow parameters, OA PSV value was significantly lower in Group 1 and Group 2 compared to Group 3 (p = 0.025, p = 0.016, respectively). However, the CRA PSV and EDV and OA EDV values, and the CRA and OA PI and RI values were not statistically different between the groups (p> 0.05). Conclusion COVID-19 infection may predispose patients to ocular vascular pathologies by affecting both choroidal and retrobulbar blood flow.
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Affiliation(s)
- Melek Tufek
- Department of Ophthalmology, Amasya University, Sabuncuoglu Serafeddin Training and Research Hospital, Amasya, Turkey.
| | - Mustafa Capraz
- Department of Internal Medicine, Amasya University, Sabuncuoglu Serafeddin Training and Research Hospital, Amasya, Turkey
| | - Ahmet Turan Kaya
- Department of Radiology, Amasya University, Sabuncuoglu Serafeddin Training and Research Hospital, Amasya, Turkey
| | - Nihat Aydin
- Department of Ophthalmology, Amasya University, Sabuncuoglu Serafeddin Training and Research Hospital, Amasya, Turkey
| | - Pinar Nalcacioglu
- Department of Ophthalmology, Yıldırım Beyazıt University Medical School, Ankara, Turkey
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16
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Kurumoğlu İncekalan T, Kışla Ekinci RM, Naz Şimdivar GH, Doğan NÇ, Çiloğlu E. Evaluation of subclinical ocular involvement in patients with deficiency of adenosine deaminase 2 (DADA2). Clin Rheumatol 2022; 41:2533-2540. [PMID: 35508675 DOI: 10.1007/s10067-022-06194-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE To evaluate changes in the peripapillary, macular, and choroidal microvasculature in the eyes of patients with deficiency of adenosine deaminase 2 (DADA2) and no clinical signs of ocular involvement. METHODS The study included 12 eyes of 12 patients with DADA2 and 24 eyes of 24 healthy subjects. The foveal avascular zone (FAZ), macular vessel densities (VDs) in the superficial and deep retinal capillary plexuses, peripapillary VDs, and choroidal thickness were evaluated by optical coherence tomography angiography (OCTA). Measurements were compared between DADA2 patients and healthy controls. RESULTS The median age was 17 (8-25) years in DADA2 patients and 17.5 (7-23) years in control group at the OCTA visit (p = 0.934). FAZ area did not differ between the groups (p = 0.224). In the superficial capillary plexus, whole-image, foveal, and parafoveal VD values were slightly lower in DADA2 patients than in controls (p = 0.054, p = 0.052, p = 0.117). In the deep capillary plexus, whole-image and parafoveal VD values were significantly lower in DADA2 patients than controls (p = 0.010, p = 0.001). VD in the radial peripapillary capillary plexus was also lower in DADA2 patients, with significantly lower peripapillary VD (p = 0.002). Subfoveal choroidal thickness was significantly higher in patients with DADA2 (p < 0.001). CONCLUSIONS This OCTA study demonstrates that both retinal and choroidal involvement may occur in DADA2 patients before the emergence of evident clinical findings.
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Affiliation(s)
- Tuğba Kurumoğlu İncekalan
- Department of Ophthalmology, University of Health Sciences Adana City Training and Research Hospital, Adana, Turkey.
| | - Rabia Miray Kışla Ekinci
- Department of Pediatric Rheumatology, University of Health Sciences Adana City Training and Research Hospital, Adana, Turkey
| | - Göksu Hande Naz Şimdivar
- Department of Ophthalmology, University of Health Sciences Adana City Training and Research Hospital, Adana, Turkey
| | - Neşe Çetin Doğan
- Department of Ophthalmology, University of Health Sciences Adana City Training and Research Hospital, Adana, Turkey
| | - Emine Çiloğlu
- Department of Ophthalmology, University of Health Sciences Adana City Training and Research Hospital, Adana, Turkey
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17
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Salehi MA, Karimi A, Mohammadi S, Arevalo JF. Spectral-domain OCT measurements in obesity: A systematic review and meta-analysis. PLoS One 2022; 17:e0267495. [PMID: 35476846 PMCID: PMC9045631 DOI: 10.1371/journal.pone.0267495] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 04/08/2022] [Indexed: 11/18/2022] Open
Abstract
Background Previous studies proposed possible applications of spectral-domain optical coherence tomography (SD-OCT) measurements in prognosticating pathologies observed in overweight/obesity, including ocular, vascular, and neurologic consequences. Therefore, we conducted a systematic review and meta-analysis to investigate the changes in the in SD-OCT measurements of the patients with higher body mass index (BMI) compared to normal weight individuals. Materials and methods We conducted a systematic search on PubMed, Scopus, and Embase. The search results underwent two-phase title/abstract and full-text screenings. We then analyzed SD-OCT measurements differences in patients with high BMI and controls, and performed meta-regression, sub-group analysis, quality assessment, and publication bias assessment. The measurements included macular thickness, cup to disc ratio, ganglion cell-inner plexiform layer (GC-IPL) and its sub-sectors, RNFL and peripapillary RNFL (pRNFL) and their sub-layers, and choroidal thickness and its sub-sectors. Results 19 studies were included in this meta-analysis accounting for 1813 individuals, 989 cases and 824 controls. There was an overall trend towards decreased thickness in high BMI patients, but only two measurements reached statistical significance: temporal retinal nerve fiber layer (RNFL) (Standardized mean difference (SMD): -0.33, 95% confidence interval (CI): -0.53 to -0.14, p<0.01) and the choroidal region 1.0 mm nasal to fovea (SMD: -0.38, 95% CI: -0.60 to -0.16, p<0.01). Conclusion Some ocular layers are thinner in patients with higher BMI than the controls. These SD-OCT measurements might correlate with adverse events related to increased body weight and have prognostic abilities. As SD-OCT is a robust, rapid and non-invasive tool, future guidelines and studies are needed to evaluate the possibility of their integration into care of the patients with obesity.
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Affiliation(s)
| | - Amirali Karimi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Mohammadi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- * E-mail:
| | - J. Fernando Arevalo
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, United States of America
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18
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Choroidal involvement in systemic vasculitis: a systematic review. J Ophthalmic Inflamm Infect 2022; 12:14. [PMID: 35377017 PMCID: PMC8980189 DOI: 10.1186/s12348-022-00292-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 03/24/2022] [Indexed: 01/19/2023] Open
Abstract
Systemic vasculitides are a large group of heterogeneous diseases characterized by inflammatory destruction of blood vessels targeting diverse organs and tissues including the eye. As the most vascularized layer of the eye, the choroid is expected to be affected in multiple systemic rheumatologic diseases with vascular involvement. While there are plenty of studies investigating retinal vascular involvement, choroidal vascular involvement in systemic vasculitides has not been investigated in isolation. However, choroidal manifestations including thickness changes, choroidal vasculitis and ischemia may be the earliest diagnostic features of systemic vasculitic diseases. Thus, multimodal imaging of the choroid may help early detection of choroidal involvement which may also have prognostic implications in these life-threatening diseases. This article aimed to review involvement of the choroid in systemic vasculitic diseases.
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19
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Ugurlu E, Pekel G, Akbulut S, Cetin N, Durmus S, Altinisik G. Choroidal vascularity index and thickness in sarcoidosis. Medicine (Baltimore) 2022; 101:e28519. [PMID: 35119002 PMCID: PMC8812671 DOI: 10.1097/md.0000000000028519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 12/11/2021] [Indexed: 01/04/2023] Open
Abstract
Sarcoidosis is a multisystem granulomatous disease which is observed worldwide. Sarcoidosis is one of the common causes of ocular inflammation. The choroidal vascularity index, defined as the ratio of the luminal area to the total choroidal area, is used as one of the biomarkers for assessing the choroid vascular state. We aimed to compare choroidal vascularity index and thickness measurements between sarcoidosis patients and healthy controls.Thirty-one patients with sarcoidosis and 31 age-gender matched healthy participants were recruited in this cross-sectional and comparative study. Choroidal vascularity index was defined as the ratio of luminal area to total choroidal area after binarization on optical coherence tomography images. Anterior segment examinations included central corneal thickness, corneal volume, anterior chamber depth, anterior chamber volume, and iridocorneal angle. Spectral-domain optical coherence tomography was used to measure peripapillary retinal nerve fiber layer thickness, choroidal thickness, and retinal vessel caliber.The mean choroidal vascularity index value was 61.6% in sarcoidosis patients and 62.4% in healthy controls (P = .69). The choroidal vascularity index and thickness were significantly correlated in both sarcoidosis (r = 0.41, P = .026) and control groups (r = 0.51, P = .006). Both the sarcoidosis and control groups had similar measured values for central corneal thickness, corneal volume, anterior chamber depth, anterior chamber volume, and iridocorneal angle (P > .05). Mean retinal nerve fiber layer, retinal arteriole and venule caliber, and choroidal thickness measurements did not differ significantly between the groups (P > .05).Sarcoidosis patients in quiescent period have similar choroidal vascularity index and thickness with healthy controls.
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Affiliation(s)
- Erhan Ugurlu
- Department of Pulmonology, Pamukkale University, Denizli, Turkey
| | - Gokhan Pekel
- Department of Ophthalmology, Pamukkale University, Denizli, Turkey
| | - Selen Akbulut
- Department of Ophthalmology, Pamukkale University, Denizli, Turkey
| | - Nazli Cetin
- Department of Pulmonology, Pamukkale University, Denizli, Turkey
| | - Sinan Durmus
- Department of Pulmonology, Pamukkale University, Denizli, Turkey
| | - Goksel Altinisik
- Department of Pulmonology, Pamukkale University, Denizli, Turkey
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20
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Gündoğan M, Vural E, Bayram N, Altunel O, Gündoğan F, Göktaş S. Change in retinal vessel diameter and choroidal thickness in patients with severe COVID-19: Change In Retinal Parameters In Patients With Severe COVID-19. Photodiagnosis Photodyn Ther 2021; 37:102674. [PMID: 34879296 PMCID: PMC8645280 DOI: 10.1016/j.pdpdt.2021.102674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 11/10/2021] [Accepted: 12/03/2021] [Indexed: 12/22/2022]
Abstract
Purpose : To compare the differences in retinal vascular structure and choroidal thickness between the active disease and post-recovery periods in COVID-19 patients and healthy controls. Material and Methods : This prospective, cross-sectional study included 30 eyes from 30 patients with severe COVID-19 and 30 eyes of 30 sex-matched healthy controls. Central macular thickness (CMT), subfoveal choroidal thickness (CT) and retinal vascular changes of patients were measured after positive polymerase chain reaction (PCR) (where the patient had COVID-19-related symptoms) and then three months after two negative PCRs. Laboratory parameters, including C-reactive protein and d-dimer levels, were also recorded. Results : The mean age of the patients was 47.90 ± 9.06 years in patients group, 49.07 ± 8.41 years in control goups (p = 0.467). In terms of choroidal thicknesses subfoveal, nasal and temporal region were significantly higher in the active disease period than control group (p = 0.019, p = 0.036, p = 0.003, respectively). When the after recovery period was compared with the control group in terms of choroidal thickness, although the choroidal thickness was higher in all regions, this difference was not found statistically significant. There was no statistically significant difference in CMT between groups (p = 0.506).The mean venous and arterial wall thicknesses were significantly higher in the active period than after recovery (p = 0.023, p = 0.013, respectively) but there were no differences between after recovery and control groups in the pairwise comparison (p = 0.851, p = 0.715, respectively). Conclusion : In patients with severe COVID-19, there are changes in thickness of the choroid and retinal vessel walls. While vascular wall thickness increases due to inflammation, the absence of lumen changes may be associated with hemodynamic variables.
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Affiliation(s)
- Medine Gündoğan
- Kayseri City Hospital, Department of Ophthalmology, Kayseri, Turkey.
| | - Esra Vural
- Kayseri City Hospital, Department of Ophthalmology, Kayseri, Turkey
| | - Nurettin Bayram
- Kayseri City Hospital, Department of Ophthalmology, Kayseri, Turkey
| | - Orhan Altunel
- Kutahya Health Sciences University, Evliya Celebi Education and Research Hospital, Department of Ophthalmology, Kutahya, Turkey
| | - Fatih Gündoğan
- Kayseri City Hospital, Department of Otolaryngology, Kayseri, Turkey
| | - Sertan Göktaş
- Kayseri City Hospital, Department of Ophthalmology, Kayseri, Turkey
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21
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Dereci S, Asik A, Direkci I, Karadag AS, Hizli S. Evaluation of eye involvement in paediatric celiac disease patients. Int J Clin Pract 2021; 75:e14679. [PMID: 34328680 DOI: 10.1111/ijcp.14679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 06/25/2021] [Accepted: 07/05/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The non-classic presentation of paediatric celiac disease (CeD) becomes increasingly common in daily practice, which requires an awareness of eye findings. The purpose of this study was to evaluate eye involvement and effect of gluten-free diet on ocular involvement in paediatric CeD patients by measuring the thicknesses of choroid and ganglion cell complex (GCC) composed of retinal nerve fibre layer, ganglion cell layer and inner plexiform layer using enhanced depth imaging optical coherence tomography. METHODS Forty-three CeD patients aged between four and 16 years (mean age: 9.9 ± 4.1, 12 boys and 31 girls) and 48 healthy children (mean age: 11.3 ± 4.1,17 boys and 31 girls) were compared. Following comprehensive eye examinations, thicknesses of choroid at three points and GCC layers (retinal nerve fibre layer at five points, ganglion cell layer and inner plexiform layer) were obtained using enhanced depth imaging optical coherence tomography. Measurement of thicknesses of choroid and GCC layers by a trained optical coherence tomography technician and an ophthalmologist who were not aware about group of children in paediatric CeD patients with 1 year gluten-free diet was carried out. RESULTS All layers of subfoveal, nasal and temporal choroid were significantly thinner in CeD than in the control group (P < .001, all, respectively). No significant difference was observed between the CeD and control groups in terms of GCC thicknesses (P > .05, all, respectively). CONCLUSION Paediatric CeD caused thinning of subfoveal, nasal and temporal areas of choroid, and this change is apparent even after 1 year gluten-free diet. This eye involvement should be more closely screened at diagnosis, and long-term clinical results of thin choroid should be determined. Thicknesses of GCC layers were not different in CeD group and may reveal the effect of diet or not involvement.
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Affiliation(s)
- Selim Dereci
- Pediatric Gastroenterology, Faculty of Medicine, Adıyaman University, Adiyaman, Turkey
| | - Abdulvahit Asik
- Pediatrics, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey
| | - Ilke Direkci
- Ophthalmology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey
| | - Ayse Sevgi Karadag
- Ophthalmology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey
| | - Samil Hizli
- Pediatric Gastroenterology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
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Aydemir GA, Aydemir E, Asik A, Bolu S. Changes in ocular pulse amplitude and choroidal thickness in childhood obesity patients with and without insulin resistance. Eur J Ophthalmol 2021; 32:2018-2025. [PMID: 34382437 DOI: 10.1177/11206721211039337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To compare choroidal thickness (CT) and ocular pulse amplitude (OPA) in childhood obesity with insulin resistance (IR) and without IR. METHODS Seventy-three childhood obesity and 62 healthy children, who were both age-matched and gender-matched, comprised the study population in this prospective study. Obesity was determined as having a body mass index (BMI) - standard deviation (SD) score that was > 2 SD.Intraocular pressure (IOP) and OPA were measured using a dynamic contour tonometer. The CT measurements were performed using enhanced depth imaging optical coherence tomography at three locations, comprising at the fovea, at a position 500 µm nasal, and also at a position 500 µm temporal to the fovea. RESULTS Mean BMI value was 28.72 ± 4.85 in the patients with childhood obesity and 21.47 ± 1.14 in the control group. The mean IOP and OPA values were determined 15.90 ± 2.30 and 14.10 ± 2.16 mm Hg, 1.50 ± 0.28 and 1.74 ± 0.32 mm Hg in the patients with childhood obesity and the control group, respectively (p < 0.001, p < 0.001). The mean subfoveal CT value was 350.50 ± 81.51 μm in the eyes with childhood obesity and 390.02 ± 71.50 μm in those of the control group (p = 0.003). When the patient groups with and without IR were compared, no significant difference was found between CT, OPA and IOP values (p > 0.005). CONCLUSIONS Our results showed that both OPA and CT values were significantly decreased in childhood obesity patients. We suggest further studies to verify longitudinal changes in OPA and CT, as also the evaluation of these parameters in other populations.
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Affiliation(s)
- Gözde Aksoy Aydemir
- Ophthalmology Department, Adıyaman University Education and Research Hospital, Adıyaman, Turkey
| | - Emre Aydemir
- Ophthalmology Department, Adıyaman University Education and Research Hospital, Adıyaman, Turkey
| | - Abdulvahit Asik
- Department of Pediatrics, Adıyaman University Education and Research Hospital, Adıyaman, Turkey
| | - Semih Bolu
- Department of Pediatrics, Adıyaman University Education and Research Hospital, Adıyaman, Turkey
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Ayar K, Can ME, Koca N, Çelik DŞ. Evaluation of retinal vascularization by optical coherence tomography angiography (OCTA) in rheumatoid arthritis, and its relationship with disease activity. Mod Rheumatol 2020; 31:817-826. [PMID: 32997565 DOI: 10.1080/14397595.2020.1830740] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To measure the retinal capillary density quantitatively with optical coherence tomography angiography (OCTA) in patients with rheumatoid arthritis (RA) and healthy controls (HCs), and to evaluate the relationship between OCTA findings and RA disease activity. METHODS In this cross-sectional study, 106 eyes of RA patients and 71 eyes of HCs were evaluated. RA patients were divided into inactive (DAS28 < 3.2) and active (DAS28 ≥ 3.2) subgroups. Retinal capillary plexus density (CPD) was obtained from the superficial capillary plexus (SCP), deep capillary plexus (DCP), and radial peripapillary capillary (RPC). RESULTS In RA patients and HCs, the CPD (%) was 50.99 ± 3.30 and 52.08 ± 2.36 (p = .013) in the SCP, 55.65 ± 5.73 and 57.53 ± 4.60 (p = .019) in the DCP, and 49.98 ± 2.25 and 49.93 ± 2.25 (p = .947) in the RPC blood supply regions, respectively. In inactive and active RA patients, the CPD (%) was 51.01 ± 2.92 and 50.97 ± 3.73 (p = .947) in the SCP, 55.02 ± 5.70 and 56.40 ± 5.74 in the DCP (p = .229), and 50.34 ± 2.23 and 49.55 ± 2.22 (p = .079) in the RPC blood supply regions, respectively. DAS28 was negatively correlated with CPD in RPC blood supply region (Rho = -0.272, p = .006). CONCLUSION In RA, retinal CPD in the macula is lower than HCs. Although retinal CPD is not generally different in active and inactive RA patients, capillaries in the optic disc may be affected by disease activity.
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Affiliation(s)
- Koray Ayar
- Department of Internal Medicine, Rheumatology Division, University of Health Sciences, Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Mehmet Erol Can
- Department of Ophthalmology, Bursa City Hospital, Bursa, Turkey
| | - Nizameddin Koca
- Department of Internal Medicine, University of Health Sciences, Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Direnç Şerif Çelik
- Department of Internal Medicine, University of Health Sciences, Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey
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24
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BAYTAROĞLU A, KADAYIFÇILAR S, AĞIN A, DELİKTAŞ Ö, DEMİR S, BİLGİNER Y, KARAKAYA J, ÖZEN S, ELDEM B. Choroidal vascularity index as a biomarker of systemic inflammation in childhood Polyarteritis Nodosa and adenosine deaminase-2 deficiency. Pediatr Rheumatol Online J 2020; 18:29. [PMID: 32245490 PMCID: PMC7118843 DOI: 10.1186/s12969-020-0417-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 03/02/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND/PURPOSE To assess EDI-OCT (enhanced depth imaging optical coherence tomography) of choroid for inflammatory signs in children with polyarteritis nodosa (PAN) and adenosine deaminase-2 deficiency (DADA-2). METHODS In this cross-sectional study conducted between June 2017 and September 2018, we evaluated children diagnosed with PAN (n = 11) and DADA-2 (n = 4) and an age- and sex-matched control group (n = 15). Demographic and laboratory data were retrospectively analyzed from patient charts. Disease activity was assessed using the pediatric vasculitis activity score (PVAS). Choroidal images were obtained with spectral domain-OCT to measure choroidal thickness (ChT) at 5 points (750 and 1500 μm from the foveal center in the temporal and nasal quadrants and beneath the fovea), and to calculate the total subfoveal choroidal area (TCA), luminal area (LA), stromal area (SA), and the choroidal vascularity index (CVI). RESULTS The median (min-max) age was 8 (4-16) years in PAN patients, 6 (5-16) years in DADA-2 patients and 8 (8-10) years in control group at the OCT visit (p = 0.214). The ChT at 3 points and the TCA, LA, and SA were higher in children with both PAN and DADA-2 patients compared to those of the control group (p < 0.0001, p = 0.049, p = 0.007, p = 0.007, p = 0.006, p = 0.033, respectively). The CVI was similar in both groups. No association was observed between the OCT findings, PVAS, and the erythrocyte sedimentation rate, and serum leukocyte and C-reactive protein levels. CONCLUSION Similar CVI scores were obtained from PAN and DADA2 patients under treatment and from healthy controls. Increased subfoveal ChT without any other signs of ocular involvement may suggest choroidal thickening as a sign of mild subclinical inflammation.
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Affiliation(s)
- Ata BAYTAROĞLU
- Department of Ophthalmology, Aydın State Hospital, Aydın, Turkey
| | - Sibel KADAYIFÇILAR
- grid.14442.370000 0001 2342 7339Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Abdullah AĞIN
- Department of Ophthalmology, Patnos State Hospital, Ağrı, Turkey
| | - Özge DELİKTAŞ
- grid.14442.370000 0001 2342 7339Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Selcan DEMİR
- grid.14442.370000 0001 2342 7339Department of Pediatrics, Pediatric Rheumatology Unit, Hacettepe University School of Medicine, Ankara, Turkey
| | - Yelda BİLGİNER
- grid.14442.370000 0001 2342 7339Department of Pediatrics, Pediatric Rheumatology Unit, Hacettepe University School of Medicine, Ankara, Turkey
| | - Jale KARAKAYA
- grid.14442.370000 0001 2342 7339Department of Biostatistics, Hacettepe University School of Medicine, Ankara, Turkey
| | - Seza ÖZEN
- grid.14442.370000 0001 2342 7339Department of Pediatrics, Pediatric Rheumatology Unit, Hacettepe University School of Medicine, Ankara, Turkey
| | - Bora ELDEM
- grid.14442.370000 0001 2342 7339Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey
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Yener AÜ, Şahin K. The association of choroidal thickness with rheumatoid factor and anti-cyclic citrullinated peptide in rheumatoid arthritis. Int Ophthalmol 2020; 40:935-941. [PMID: 31927678 DOI: 10.1007/s10792-019-01265-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 12/28/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE To measure ocular vascular parameters in rheumatoid arthritis patients and compare with those of controls and to evaluate the association of rheumatoid factor and anti-cyclic citrullinated peptide antibody with the choroidal thickness. METHODS Superficial foveal vessel density, superficial and deep foveal avascular zone area, and subfoveal choroidal thickness were measured using the swept-source optical coherence tomography angiography. Multivariate linear regression was used to assess the correlation of subfoveal choroidal thickness with serological markers in patients with rheumatoid arthritis. RESULTS Choroidal thickness in patients was significantly thinner than that in healthy controls (278.87 ± 59.54 μm vs. 323.94 ± 98.02 μm, p = 0.03). Despite the weak positive correlations between rheumatoid factor/anti-cyclic citrullinated peptide and choroidal thickness, these relationships were not statistically significant (p > 0.05). CONCLUSIONS In patients with rheumatoid arthritis, subfoveal choroid was thinner than controls. There were similar correlations between choroidal thickness and rheumatoid factor and anti-cyclic citrullinated peptide antibody.
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Affiliation(s)
- Arif Ülkü Yener
- Department of Ophthalmology, Keçiören Training and Research Hospital, Ankara, Turkey.
| | - Kubilay Şahin
- Department of Rheumatology, Keçiören Training and Research Hospital, Ankara, Turkey
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26
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Steiner M, Esteban-Ortega MDM, Muñoz-Fernández S. Choroidal and retinal thickness in systemic autoimmune and inflammatory diseases: A review. Surv Ophthalmol 2019; 64:757-769. [PMID: 31034855 DOI: 10.1016/j.survophthal.2019.04.007] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 04/14/2019] [Accepted: 04/22/2019] [Indexed: 12/22/2022]
Abstract
To identify the risk of relapse and subclinical inflammatory stages of systemic autoimmune diseases, new tools are needed. In the recent years, choroidal thickness and retinal thickness measured with ocular coherence tomography (OCT) have been proposed as an inflammatory marker for different systemic diseases, especially for conditions with a vascular component. Our aim in this article is to review the literature regarding the role of choroidal and retinal thickness as a potential inflammatory marker in systemic autoimmune and inflammatory diseases measured by OCT. Current literature suggests that the choroid of patients thickens in active phases of inflammatory diseases with vascular involvement. This pattern is observed in lupus, systemic sclerosis, Behçet disease, spondylitis, and familial Mediterranean fever. Choroidal thickness may decrease with biological treatments, along with systemic inflammation. Repeated flares and long-term disease, however, may thin the choroid, as a result of prolonged insult to the microvasculature and subsequent atrophy. Less is known about the effect of these diseases on retinal thickness. In summary, choroidal and retinal thickness measured by OCT may be promising markers for inflammation in systemic autoimmune and inflammatory diseases; however, more studies are warranted before generalizing choroidal thickness measurements by OCT as a marker for disease activity. The role of retinal thickness is more unclear due to a lack of studies in this field.
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Affiliation(s)
- Martina Steiner
- Department of Rheumatology, Infanta Sofía University Hospital, San Sebastián de los Reyes, Madrid, Spain; Universidad Europea de Madrid, Madrid, Spain.
| | - Maria Del Mar Esteban-Ortega
- Universidad Europea de Madrid, Madrid, Spain; Department of Ophthalmology, Infanta Sofía University Hospital, San Sebastián de los Reyes, Madrid, Spain
| | - Santiago Muñoz-Fernández
- Department of Rheumatology, Infanta Sofía University Hospital, San Sebastián de los Reyes, Madrid, Spain; Universidad Europea de Madrid, Madrid, Spain
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27
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Mukherjee C, Al-Fahad Q, Elsherbiny S. The role of optical coherence tomography in therapeutics and conditions, which primarily have systemic manifestations: a narrative review. Ther Adv Ophthalmol 2019; 11:2515841419831155. [PMID: 30923793 PMCID: PMC6431765 DOI: 10.1177/2515841419831155] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Accepted: 01/22/2019] [Indexed: 12/22/2022] Open
Abstract
Optical coherence tomography is designed to evaluate in vivo qualitative and quantitative changes of the anterior segment, optic nerve and the retina. Initial applications of this technology were confined mainly to ophthalmic diseases. However recently, numerous studies have evaluated its use in systemic conditions and in therapeutics where, optic nerve and retinal architecture can be assessed to monitor progression of systemic conditions and its response to treatment. This is a narrative review aimed at evaluating the debate surrounding the role of spectral domain optical coherence tomography, in systemic conditions where optic nerve affection can be measured and be used in the diagnosis, monitoring and assessment of treatment effect as a non-invasive, quick, novel technique.
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Affiliation(s)
| | - Qusay Al-Fahad
- Birmingham Midland Eye Centre, Birmingham, UK; Machen Eye Unit, South Warwickshire Foundation Trust, Warwick, UK
| | - Samer Elsherbiny
- Birmingham Midland Eye Centre, Birmingham, UK; Machen Eye Unit, South Warwickshire Foundation Trust, Warwick, UK
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28
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Can ME, Unal Ö, Kars ME, Erten S, Dereli Can G, Duru N, Cagil N. An assessment of ocular elasticity using real time ultrasound and ocular response analyzer in active or remission rheumatoid arthritis. Int Ophthalmol 2018; 39:2187-2194. [PMID: 30511206 DOI: 10.1007/s10792-018-1055-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 11/26/2018] [Indexed: 02/01/2023]
Abstract
PURPOSE To investigate the elasticity of ocular structures in patients with rheumatoid arthritis (RA) without ocular involvement. METHODS The study included 56 RA patients (study group) and 24 healthy volunteers as the control group. The rheumatoid arthritis patients were divided into two subgroups as those in active phase (Group 1, n = 25) or in remission phase (Group 2, n = 31) according to the disease activity index (DAS 28) score. The elastography values of the ratio of orbital fat-sclera (ROF/S) were measured with real-time US elastography, and corneal mechanical values were measured with the Reichert Ocular Response Analyzer in each eye. RESULTS The mean ROF/S value was 5.2 ± 1.8 in Group 1, 0.7 ± 0.4 Group 2, and 0.6 ± 0.1 in the control group. There was a significant difference between the Group 1 and control group with regard to ROF/S (p < 0.001), but no significant difference was determined between Group 2 and control group (p > 0.05). The mean ROF/S value was a significant difference between the Group 1 and 2 (p < 0.001). ROF/S was significantly correlated with DAS-28 and C-reactive protein (CRP) (r = 0.816, p < 0.001 and r = 0.259, p = 0.006). CONCLUSIONS ROF/S was significantly increased in patients in the active phase of RA. Findings revealed that ocular tissue structural changes may occur in the active phase and these could be related to ocular complications as a prognostic factor.
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Affiliation(s)
- Mehmet Erol Can
- Department of Ophthalmology, Yuksek Ihtisas Training and Research Hospital, Mimarsinan Mahallesi Emniyet Caddesi Polis Okulu Karşısı, Bursa, Turkey.
| | - Özlem Unal
- Department of Radiology, Yildirim Beyazit University Faculty of Medicine, Ankara Ataturk Training and Research Hospital, Ankara, Turkey
| | - Meltem Ece Kars
- Department of Ophthalmology, Yildirim Beyazit University Faculty of Medicine, Ankara Ataturk Training and Research Hospital, Ankara, Turkey
| | - Sukran Erten
- Department of Rheumatology, Yildirim Beyazit University Faculty of Medicine, Ankara Ataturk Training and Research Hospital, Ankara, Turkey
| | - Gamze Dereli Can
- Department of Ophthalmology, Yuksek Ihtisas Training and Research Hospital, Mimarsinan Mahallesi Emniyet Caddesi Polis Okulu Karşısı, Bursa, Turkey
| | - Necati Duru
- Department of Ophthalmology, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Nurullah Cagil
- Department of Ophthalmology, Yildirim Beyazit University Faculty of Medicine, Ankara Ataturk Training and Research Hospital, Ankara, Turkey
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Abstract
PURPOSE To evaluate choroidal morphology and thickness at the posterior pole of individuals affected by multisystemic autoimmune diseases and without known ophthalmologic manifestations. METHODS Retrospective cross-sectional study including 75 patients with autoimmune diseases (divided according to their specific disease) and 80 healthy controls. A spectral-domain optical coherence tomography using enhanced depth imaging was performed and choroidal thickness was measured in the center of fovea and at 500 μm intervals along a horizontal section. RESULTS Lupus patients presented a thicker subfoveal choroid than controls (408.624 vs. 356.536, P < 0.001) and in all the other measurements (P < 0.001 to P = 0.003). Rheumatoid arthritis and other autoimmune diseases had an overall thinner choroid than controls (297.867 vs. 356.536 subfoveally, P = 0.004; P = 0.005-0.019 in other measurements). Results were adjusted for the covariates age (P = 0.007), spherical equivalent (P < 0.001), and systemic steroids dose (P = 0.004). Hypertension (P = 0.102), diabetes mellitus (P = 0.672), time since the beginning of therapy with hydroxychloroquine (P = 0.104) and its cumulative dose (P = 0.307), or use of other immunosuppressives (P = 0.281) had no influence on the mean choroidal thickness. No morphologic abnormalities were found. CONCLUSION The choroid may be subclinically involved in autoimmune diseases. However, the choroidal response seems to differ depending on the autoimmune disease. Infiltrative mechanisms specific for lupus may justify the thickened choroid found in these patients.
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30
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Can ME, Kaplan FE, Uzel MM, Kiziltoprak H, Ergun MC, Koc M, Simsek G. The association of Helicobacter pylori with choroidal and retinal nerve fiber layer thickness. Int Ophthalmol 2017; 38:1915-1922. [PMID: 28780617 DOI: 10.1007/s10792-017-0677-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 08/01/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE To investigate the effect of Helicobacter pylori (H. pylori) infection on choroidal thickness (CT) and retinal nerve fiber layer thickness (RNFLT). METHODS The study included 25 patients with H. pylori infection and 25 healthy individuals as the control group. Helicobacter pylori patients were classified as the pre-treatment (Group 1; n: 25) and the post-treatment (Group 2; n: 25). RNFLT and CT were measured before and after treatment of H. pylori infection, using enhanced depth imaging (EDI) spectral-domain optical coherence tomography (Spectralis, Heidelberg Engineering, Heidelberg, Germany). The axial length and intraocular pressure were also measured. RESULTS The mean subfoveal CT was 320.96 ± 29.15 μm in Group 1 and 287.48 ± 49.17 in the control group (p = 0.007), while the mean subfoveal CT did not show any difference between Group 2 and the control group (p > 0.05). No statistically significant difference was determined between the H. pylori patients and the control group in respect of RNFLT values (p > 0.05). CONCLUSIONS CT increases during H. pylori infection and returns to the normal range within 6 weeks of treatment. RNFLT does not show any change during H. pylori infection. The data related to the subfoveal CT may be useful in understanding the pathogenesis of central serous chorioretinopathy developing in H. pylori patients.
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Affiliation(s)
- Mehmet Erol Can
- Department of Ophthalmology, Kecioren Training and Research Hospital, Yasamkent Mah. 3208 Sk. Gulbeng Sitesi No: 1-49, Cankaya, Ankara, Turkey.
| | - Fatma Efe Kaplan
- Department of Internal Medicine, Kecioren Training and Research Hospital, Ankara, Turkey
| | | | - Hasan Kiziltoprak
- Department of Ophthalmology, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Mustafa Cagri Ergun
- Department of Internal Medicine, Kecioren Training and Research Hospital, Ankara, Turkey
| | - Mustafa Koc
- Department of Ophthalmology, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Gülcin Simsek
- Department of Pathology, Kecioren Training and Research Hospital, Ankara, Turkey
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Kal A, Duman E, Sezenöz AS, Ulusoy MO, Kal Ö. Evaluation of retrobulbar blood flow and choroidal thickness in patients with rheumatoid arthritis. Int Ophthalmol 2017; 38:1825-1831. [PMID: 28730400 DOI: 10.1007/s10792-017-0656-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 07/15/2017] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate whether retrobulbar blood flow and choroidal thickness (CT) are affected in patients with rheumatoid arthritis (RA), and the relationship between these values. METHODS We evaluated 40 eyes of 20 RA patients and 40 eyes of 20 healthy controls. The enhanced depth imaging optical coherence tomography, color Doppler imaging, was held. Statistical analysis was performed. RESULTS Peak systolic velocity (PSV) of ophthalmic (OA) and central retinal artery (CRA) were significantly higher in RA. No significant difference was observed when end-diastolic velocity (EDV) of OA and CRA was compared between the groups. The resistivity index (RI) of OA and CRA was higher in RA. Perifoveal/subfoveal CT was lower in RA. Negative correlation was detected between the RI of OA and the perifoveal CT, and a positive correlation was detected between RI of CRA and CT. CONCLUSIONS Ocular hemodynamics is effected by RA and can exaggerate ocular complications of various vascular diseases such as diabetes mellitus, hypertension, retinal vascular occlusions.
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Affiliation(s)
- Ali Kal
- Department of Ophthalmology, Baskent University, Konya, Turkey.
- Göz Hastaliklari ABD, Baskent Üniversitesi Tıp Fakültesi, Hoca Cihan Mh. Saray Cd.No:1, 42080, Konya, Turkey.
| | - Enes Duman
- Department of Radiology, Baskent University, Konya, Turkey
| | | | | | - Öznur Kal
- Department of Nephrology, Baskent University, Konya, Turkey
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32
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Karti O, Ayhan Z, Zengin MO, Kaya M, Kusbeci T. Choroidal Thickness Changes in Rheumatoid Arthritis and the Effects of Short-term Hydroxychloroquine Treatment. Ocul Immunol Inflamm 2017; 26:770-775. [DOI: 10.1080/09273948.2017.1278777] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Omer Karti
- Departmant of Ophthalmology, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Ziya Ayhan
- Department of Ophthalmology, Dokuz Eylul University, Izmir, Turkey
| | - Mehmet Ozgur Zengin
- Departmant of Ophthalmology, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Mahmut Kaya
- Department of Ophthalmology, Dokuz Eylul University, Izmir, Turkey
| | - Tuncay Kusbeci
- Departmant of Ophthalmology, Bozyaka Training and Research Hospital, Izmir, Turkey
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Bulus AD, Can ME, Baytaroglu A, Can GD, Cakmak HB, Andiran N. Choroidal Thickness in Childhood Obesity. Ophthalmic Surg Lasers Imaging Retina 2017; 48:10-17. [DOI: 10.3928/23258160-20161219-02] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 10/05/2016] [Indexed: 12/30/2022]
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34
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Cunningham ET, Ferrara D, Mrejen S, Freund KB, Zierhut M. Imaging the Choroid and Choroidal Neovascularization in Eyes with Inflammation. Ocul Immunol Inflamm 2016; 24:243-5. [DOI: 10.1080/09273948.2016.1180040] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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35
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Yumusak E, Ornek K, Durmaz SA, Cifci A, Guler HA, Bacanli Z. Choroidal thickness in obese women. BMC Ophthalmol 2016; 16:48. [PMID: 27142207 PMCID: PMC4855894 DOI: 10.1186/s12886-016-0227-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 04/28/2016] [Indexed: 12/27/2022] Open
Abstract
Background Excessive weight is a well-known risk factor for microvascular diseases. Changes in thickness in a vascular tissue, such as the choroid, can be useful to evaluate the effect of obesity on the microvascular system. The aim of this study was to evaluate the choroidal thickness (CT) changes in obese women, using optical coherence tomography (OCT). Methods The prospective clinical study included examination of the right eyes of 72 patients. The right eyes of 68 patients were examined and served as the controls. A complete ophthalmological examination and OCT imaging were performed for each group studied. The CT in each eye was measured using OCT. Results The obese group consisted of 72 female patients with a mean age of 37.27 ± 1.18 years. The control group included 68 female subjects with a mean age of 37.85 ± 7.98 years (p > 0.05). There was no statistical significant difference for the foveal retinal thickness measurements between the two groups (p > 0.5). Our study revealed significant choroidal tissue thickening subfoveally and at areas 500 μm temporal, 500 μm nasal, and 1500 μm nasal to the fovea in the obese group (all p < 0.05). There was a positive correlation between body mass index (BMI) and CT changes. Conclusions CT may increase in obese women and a positive correlation was found between BMI and CT. The trial protocol was approved by the Local Ethical Committee of the Kırıkkale University, date of registration: April 27, 2015 (registration number: 10/11).
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Affiliation(s)
- Erhan Yumusak
- Department of Ophthalmology, Kırıkkale University, School of Medicine, Kırıkkale, Turkey.
| | - Kemal Ornek
- Department of Ophthalmology, Kırıkkale University, School of Medicine, Kırıkkale, Turkey
| | - Senay Arıkan Durmaz
- Department of Endocrinology, Kırıkkale University, School of Medicine, Kırıkkale, Turkey
| | - Aydin Cifci
- Department of Internal Medicine, Kırıkkale University School of Medicine, Kırıkkale, Turkey
| | - Hatice Ayhan Guler
- Department of Ophthalmology, Kırıkkale University, School of Medicine, Kırıkkale, Turkey
| | - Zehra Bacanli
- Department of Internal Medicine, Kırıkkale University School of Medicine, Kırıkkale, Turkey
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The Impact of Chronic Tobacco Smoking on Retinal and Choroidal Thickness in Greek Population. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2016; 2016:2905789. [PMID: 26885247 PMCID: PMC4738968 DOI: 10.1155/2016/2905789] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 12/21/2015] [Indexed: 11/19/2022]
Abstract
Aim. To investigate the effect of more than 25-year cigarette smoking on choroidal and retinal thickness, using spectral domain optical coherence tomography (SD-OCT). Methods. Thirty-one smokers and 25 age- and sex-matched nonsmokers, serving as control group, were submitted to slit-lamp biomicroscopy and dilated fundoscopy, SD-OCT, measurements of intraocular pressure (IOP), central corneal thickness (CCT), and axial length (AL). Heidelberg Spectralis was used to calculate choroidal thickness (CT), ganglion cell complex (GCC), outer retina layers (ORL), and macular thicknesses (MT). Results. The smokers' group consisted of 17 males and 14 females with mean age of 57.8 ± 4.5 years, while the controls' group consisted of 14 males and 11 females with mean age of 68.0 ± 4.1 years. CT and GCC thicknesses were significantly reduced in smokers compared to control group. The differences in thicknesses of ORL were marginally significant between two groups. The measurements of MT, IOP, CCT, and AL had the same distributions between smokers and nonsmokers. Conclusions. Tobacco smoking seems to result in thinner choroid and retina compared to nonsmokers. This is the first study in literature that investigates the anatomical effect of smoking for more than 25 years on the choroid and retina.
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