Çocuk Çölyak Hastalarında Laboratuvar Parametrelerinin Göz Yaşı Testleri ve Optik Koherens Tomografi Bulguları Üzerindeki Etkisi

Year 2022, , 121 - 125, 30.08.2022

Mustafa Vatansever , Özer Dursun , Özlem Tezol , Erdem Dinç , Esra Danacı Vatansever , Ayça Sarı , Yusuf Usta

https://doi.org/10.18678/dtfd.1082300

Abstract

Amaç: Bu çalışmanın amacı çölyak hastalığı (ÇH) olan çocuklarda gözyaşı parametreleri ve optik koherens tomografi (OKT) bulgularını değerlendirmek ve bu bulgular ile laboratuvar verileri arasındaki ilişkiyi araştırmaktır.
Gereç ve Yöntemler: Çalışmaya ÇH nedeniyle takip edilen 50 hastanın 100 gözü ile herhangi bir oküler patolojisi olmayan 55 sağlıklı katılımcının 110 gözü dahil edildi. Tüm katılımcıların en iyi düzeltilmiş görme keskinliği değerlendirildi, standart Schirmer testi kullanılarak gözyaşı miktarı belirlendi ve floresein ile gözyaşı kırılma zamanı (GKZ) belirlendi. Pupiller dilatasyon sağlandıktan sonra maküla kesitleri ve optik disk kesitleri OKT cihazı ile alındı.
Bulgular: Yaş ve cinsiyet dağılımı bakımından hasta ve kontrol grupları arasında istatistiksel olarak anlamlı farklılık yoktu (sırasıyla, p=0,490 ve p=0,930). Ortalama Schirmer testi değeri kontrol grubu ile karşılaştırıldığında ÇH hastalarında anlamlı olarak daha düşüktü (14,07±5,14 mm’ye karşı 20,20±3,93 mm, p<0,001). Ayrıca GKZ değeri sağlıklı katılımcılar ile karşılaştırıldığında ÇH hastalarında anlamlı olarak daha kısaydı (10,86±3,51 s’ye karşı 15,25±2,49 s, p<0,001). Ortalama total retina kalınlığı ve dış retina kalınlığı değerleri hasta grubunda kontrol grubuna göre anlamlı olarak daha düşüktü (her iki parametre için p<0,001). Ayrıca, ortalama retina sinir lifi (ORSL) kalınlığı kontrol grubu ile karşılaştırıldığında hasta grubunda anlamlı olarak daha inceydi (p<0,001).
Sonuç: Sunulan bu çalışmada ÇH olan çocuklarda maküla ve ORSL kalınlığının kontrol grubuna göre azaldığı ve gözyaşı testlerinin de bozulduğu görülmüştür.

Keywords

Çölyak hastalığı, laboratuar parametreleri, gözyaşı filmi, optik koherens tomografi, çocuk hastalar

Effects of Laboratory Parameters on Tear Tests and Optical Coherence Tomography Findings in Pediatric Celiac Disease

Abstract

Aim: The aim of this study was to evaluate the tear parameters and optical coherence tomography (OCT) findings in children with celiac disease (CD) and to investigate the relationship between these findings and laboratory data.
Material and Methods: The study included 100 eyes of 50 CD patients as well as 110 eyes of 55 healthy subjects with no ocular pathology as a control group. Best corrected visual acuity was evaluated, baseline tear volume was estimated using standard Schirmer’s test, and fluorescein tear film break-up time (TBUT) was determined for all participants. Pupillary dilation was induced and macular sections and optic disc sections were obtained with OCT.
Results: The patient and control groups showed no statistically significant differences in terms of age and gender distribution (p=0.490, and p=0.930, respectively). Mean Schirmer’s test measurement was significantly lower in the CD patients compared to the control group (14.07±5.14 mm vs. 20.20±3.93 mm, p<0.001). TBUT was also shorter in the CD patients compared to the control subjects (10.86±3.51 s vs. 15.25±2.49 s, p<0.001). Mean total retinal thickness and outer retinal thickness values were significantly lower in the patient group than in the control group (p<0.001, for both parameters). In addition, the mean retinal nerve fiber layer (RNFL) thickness measurement was significantly thinner in the patient group than in the control group (p<0.001).
Conclusion: In the presented study, it was observed that macular and RNFL thickness were decreased in children with CD compared to the control group, and tear tests were also impaired.

Keywords

Celiac disease, laboratory parameters, tear film, optical coherence tomography, pediatric patients

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