İkinci ve üçüncü trimester gebelerde artırılmış derinlik optik koherens tomografi ile koroid kalınlık ölçümü

Year 2019, Volume: 3 Issue: 2, 159 - 163, 23.08.2019

Özkan Kocamış , Selda Dağlı

https://doi.org/10.30565/medalanya.550500

Abstract

Amaç: Gebelerde ikinci ve üçüncü trimesterde artırılmış derinlik görüntüleme (Enhanced Depth İmaging –EDİ) Optik Koherens Tomografi (OKT) kullanarak koroid kalınlıgı belirlemek. 

Yöntemler: Bu calısmada 40 gebe ile gebe olmayan (kontrol) 40 sağlıklı kadının her iki gözü EDİ-OKT kullanarak subfoveal, 2 mm nazal, 2 mm temporal koroidal kalınlıkları değerlendirildi. Gebelerden 20’ si 16-24. haftalar arası (ikinci trimester), 20’ si 24-39. haftalar arası (üçüncü trimester) olarak 2 gruba ayrıldi. Yaş ortalaması gebelerde 27.4±5.8, kontrol grubunda 26.9±7.1 olarak hesaplandı. 

Bulgular: Gebelerde koroid kalınlıkları EDİ-OKT ile sağ gözde subfoveal 295.3±51.8μm, 2 mm nazal 242.4±49.2μm (p=0.032); 2 mm temporal 252.3±52.9μm (p=0.001) iken sol göz ölçümlerinde subfoveal 298.4±66.7μm, 2 mm nazal 251.5±54.7μm, 2 mm temporal 263.6±64.3μm (p=0.044) olarak kaydedildi. Kontrol grubunda sağ göz subfoveal 307.8±64.5μm, 2 mm nazal 267.6±54.2μm, 2 mm temporal 292.9±50.9μm, sol göz subfoveal 295.3±71.3μm, 2 mm nazal 269.6±63.7μm, 2 mm temporal 292.0±59.5μm olarak ölçüldü. Gebe grubu ile kontrol grubu koroid kalınlığı karşılaştırıldığında sağ göz 2 mm nazal (p=0.032) ve 2 mm temporal (p=0.001) alanlar ile sol göz 2 mm temporal (p=0.044) alanda kalınlık kontrol grubunda daha yüksek olup istatistiksel olarak anlamlı fark saptanmıştır. Diğer bölgelerde fark bulunmamıştır (p>0.05). 

Sonuç: Bu çalışmada gebe hastalarda benzer yaş grubu ile kıyaslandığında EDİ OKT ile yapılan koroid kalınlık ölçümünün daha ince olduğu tespit edilmiştir. 

Keywords

Koroid Kalınlığı, Optik koherans tomografi, Gebelik, Retina

Choroid thickness measurement in second and third trimester pregnancies by enhanced depth imaging optical coherence tomography

Abstract

Aim: Evaluation of choroid thickness in 2nd and 3rd trimester pregnancies by Enhanced Depth Imaging –EDI Optic Coherence Tomography (OCT). 

Patients and Methods: In this study, the subfoveal, 2 mm nasal, 2 mm temporal choroidal thicknesses of both eyes in 40 pregnant and 40 non-pregnant (control) women were evaluated. The pregnant women were categorized in 2 groups, 20 being 16-24 weeks pregnant (second trimester) and 20 being 24-39 weeks pregnant (third trimester). The average age of the pregnant women and non-pregnant women was calculated as 27.4±5.8 and 26.9±7.1, respectively. 

Results: The choroid thicknesses in the pregnant women were recorded by EDI-OCT as follows; right eye subfoveal 295.3±51.8μm, 2 mm nasal 242.4±49.2μm, 2 mm temporal 252.3±52.9μm and left eye subfoveal 298.4±66.7μm, 2 mm nasal 251.5±54.7μm, 2 mm temporal 263.6±64.3μm. The control group was recorded as follows; right eye subfoveal 307.8±64.5μm, 2 mm nasal 267.6±54.2μm, 2 mm temporal 292.9±50.9μm and left eye subfoveal 295.3±71.3μm, 2 mm nasal 269.6±63.7μm, 2 mm temporal 292.0±59.5μm. The comparison of the choroid thicknesses in the pregnant subjects and the control group shows that the thickness in the 2 mm nasal (p=0.032) and 2 mm temporal (p=0.001) areas of the right eye and 2 mm temporal (p=0.044) area of the left eye is significantly different. No significant difference was observed in the other areas (p>0.05) 

Conclusions: In this study, choroidal thickness measurement with EDI OCT was found to be thinner in pregnant patients compared to similar age group. 

Keywords

Choroid Thickness, Pregnancy, Optic Cohorence Tomography, Retina

References

• 1. Chapman AB, Abraham WT, Zamudio S, Coffin C, Merouani A, Young D et al Temporal relationships between hormonal and hemodynamic changes in early human pregnancy. Kidney Int. 1998; 54:2056–63 doi:10.1046/j.1523-1755.1998.00217.x
• 2. Moutquin JM, Rainville C, Giroux L, Raynauld P, Amyot G, Bilodeau R et al A prospective study of blood pressure in pregnancy: prediction of preeclampsia. Am J Obstet Gynecol.1985;151:191-6 doi:10.1016/0002-9378(85)90010-9
• 3. Macdonald-Wallis C, Tilling K, Fraser A, Nelson SM, Lawlor DA. Established pre-eclampsia risk factors are related to patterns of blood pressure change in normal term pregnancy: findings from the Avon Longitudinal Study of Parents and Children (ALSPAC). J Hypertens. 2011; 29:1703-11. doi: 10.1097/HJH.0b013e328349eec6
• 4. Cankaya C, Bozkurt M, Ulutas O. Total macular volume and foveal retinal thickness alterations in healthy pregnant women. Semin Ophthalmol. 2013; 28:103-5. doi:10.3109/08820538.2012.760628
• 5. Cioffi GA, Granstam C,Alm A. Ocular circulation. In:Kaufman PL,Alm A, editors.Ader’s physiology of the eye: clinical application. 10th edSt. Louis: Mosby . P.2003;747-84
• 6. Errera M-H, Kohly RP, DA Cruz L.Pregnancy-associated retinal diseases and their management. Surv Ophthalmol.2013; 58:127–42. doi: 10.1016/j.survophthal.2012.08.001
• 7. Ataş M, Duru N, Ulusoy DM, Altınkaynak H, Duru Z, Açmaz G et al Evaluation of anterior segment parameters during and after pregnancy. Contact Lens Anterior Eye. 2014;37:447–50. doi: 10.1016/j.clae.2014.07.013
• 8. Haimovici R,Koh S, Gagnon DR, Lehrfeld T, Wellik S. Risk factors for central serous chorioretinopathy: a case-control study. Ophthalmology 2004;111:244–9 doi: 10.1016/j.ophtha.2003.09.024
• 9. Tsuiki E, Suzuma K, Ueki R, Maekawa Y, Kitaoka T. Enhanced depth imaging optical coherence tomography of the choroid in central retinal vein occlusion. Am J Ophthalmol.2013;156:543–7. doi: 10.1016/j.ajo.2013.04.008.
• 10. Imamura Y, Fujiwara T, Margolis R,  Spaide RF. Enhanced depth imaging optical coherence tomography of the choroid in central serous chorioretinopathy. Retina Phila Pa. 2009; 29:1469–73 doi: 10.1097/IAE.0b013e3181be0a83
• 11. Spaide RF, Koizumi H, Pozonni MC Enhanced depth imaging spectral-domain optical coherence tomography. Am J Ophthalmol2008;146:496–500. doi: 10.1016/j.ajo.2008.05.032.
• 12. Margolis R, Spaide R. A pilot study of enhanced depth imaging optical coherence tomography of the choroid in normal eyes. AmJ Ophthalmol.2009; 147:811–5. doi: 10.1016/j.ajo.2008.12.008
• 13. Savaş HB, Köse SA, Güler M, Gültekin F. [The relationship between the second trimester screening biochemical markers and complications and anomalies in pregnant women.] Acta Med. Alanya 2017;1(1):7-10. Turkish Doi: 10.30565/medalanya.265994
• 14. Lareiprele G, Valensise H, Vasapollo B, Altomare F, Sorge R, Casalino B et al Body composition during normel pregnancy: refernce range. Acta Diabctol.2003; 40:225 -232 doi:10.1007/s00592-003-0072-4
• 15. Nickla DL, Wallman J. The multifunctional choroid. Prog Retin Eye Res. 2010; 29:144 -168  doi: 10.1016/j.preteyeres.2009.12.002
• 16. Goldich Y, Cooper M, Barkana Y, Tovbin J, Lee Ovadia K, Avni I et al Ocular anterior segment changes in pregnancy. J Cataract Refract Surg.2014; 40:1868 –71 doi: 10.1016/j.jcrs.2014.02.042
• 17. Manjunath V, Gren J, Fujimoto JG, Duker JS. Analysis of choroidal thickness in age-related macular degeneration using spectral-domain optical coherence tomography. Am J Ophthalmol.2011; 152:663-668 doi: 10.1016/j.ajo.2011.03.008
• 18. Kim SW, Oh J, Kwon SS, Yoo J, Huh K. Comparision of choroidal thickness among patients with healthy eyes, early age-related maculopathy, neovascular age-related macular degeneration, central serous chorioretinopathy and polyypoidal choroidal vacsulopathy. Retina 2011; 31:1904-1911 doi: 10.1097/IAE.0b013e31821801c5
• 19. Harada T, Machida S, Fujiwara T, Nishida Y, Kurusaka D. Choroidal findings in idiopathic uveal effusion syndrome. Clin Ophthalmol.2011; 5:1599-1601 doi: 10.2147/OPTH.S26324
• 20. Nakai K, Gomi F, Ikuno Y, Yasuno Y, Nouchi T,Ohguro N et al Choroidal observations in Vogt-Koyanagi-harada disease using high-penetration optical coherence tomography. Graefes Arch clin Exp Ophthalmol.2012; 2:1089-1095 doi: 10.1007/s00417-011-1910-7
• 21. Esmaeelpour M, Povazay B, Hernann B,Hofer B, Kajie V, Hale SL et al Mapping choroidal and retinal thickness variation in type 2 diabetes using three-dimensional 1060-nm optical coherence tomography. İnvest Ophthalmol Vis Sci. 2011;52:5311-5316 doi: 10.1167/iovs.10-6875
• 22. Kara N, Sayin N, Pirhan D, Vural AD, Araz-Ersan HB, Tekirdag AI et al Evaluation of subfoveal choroidal thickness in pregnant women using enhanced depth imaging optical coherence tomography. Curr Eye Res.2014; 39:642-7 doi: 10.3109/02713683.2013.855236
• 23. Sayin N, Kara N, Pirhan D, Vural A, Araz Ersan HB, Tekirdag AI et al Subfoveal choroidal thickness in pre-eclampsia: comparison with normal pregnant and nonpregnant women. Semin Ophthalmol.2014; 29:11–17. doi: 10.3109/08820538.2013.839813
• 24. Takahashi J, Kado M, Mizumoto K,  Igarashi S, Kojo T. Choroidal thickness in pregnant women measured by enhanced depth imaging optical coherence tomography. Jpn J Ophthalmol.2013; 57:435–9 doi: 10.1007/s10384-013-0265-5
• 25. Ulusoy MD, Duru N, Atas M, Altinkaynak H, Duru Z, Acmaz G. Measurement of choroidal thickness abd macular thickness during and after pregnancy İnt J Ophthalmol. 2015; 8:312-325 doi: 10.3980/j.issn.2222-3959.2015.02.19