Choroidal and retinal changes in patients with allergic rhinoconjunctivitis

Abstract

Purpose: Allergic rhinoconjunctivitis (ARC) is an allergic upper respiratory tract disease characterized by sneezing, runny nose, nasal congestion and ocular and nasal itching due to inflammation of the nasal and conjunctival mucosa. There are no studies evaluating both the choroidal and retinal areas in ARC patients. Our objective was to evaluate patients with ARC at the time of diagnosis and before initiating treatment using Optical Coherence Tomography (OCT). Material and methods: This prospective cross-sectional study included 30 patients with ARC who presented to the Pediatric Allergy & Immunology Outpatient Clinic and 30 healthy control individuals. OCT scans were captured with Cirrus HD OCT-5000 (Carl Zeiss, Jena, Germany) in the enhanced depth imaging (EDI) mode. Results: Of the study population, 66.7% (n=20) of patient group and 56.6% (n=17) of control group were female. The mean age was 13±2.3 and 13.9±1.8 years in the patient and control groups, respectively. The temporal subfoveal choroidal thickness was statistically significantly thinner in ARC patients with asthma (p=0.032). A robust negative correlation was found between minimum ganglion cell-inner plexiform layer (GCIPL) thickness and absolute eosinophil count (AEC) in patients with ARC (r:-0.551, p<0.0001). Conclusion: In our study, the GCIPL thickness was lower in ARC patients. Similarly, although it did not reach statistical significance, the minimum GCIPL thickness was lower in our patient group with asthma compared to those without asthma. Our results suggest that multiple allergen sensitization and elevated eosinophils may influence GCIP thickness. However, both choroidal and retinal tissue might be impacted during chronic followup. Further studies are needed to support these findings.

Keywords

• Retina
• allergy
• rinitis
• choroid

Alerjik rinokonjonktivitli hastalarda koroid ve retina değişiklikleri

Abstract

Amaç: Alerjik rinokonjonktivit (ARK), burun ve konjonktival mukozanın iltihaplanmasına bağlı olarak hapşırma, burun akıntısı, burun tıkanıklığı ve gözde ve burunda kaşıntı ile karakterize alerjik bir üst solunum yolu hastalığıdır. ARK hastalarında hem koroid hem de retina bölgelerini değerlendiren çalışma bulunmamaktadır. Amacımız ARK'lı hastaları tanı anında ve tedaviye başlamadan önce Optik Koherens Tomografi (OKT) kullanarak değerlendirmek. Gereç ve yöntem: Bu prospektif kesitsel çalışmaya Çocuk Alerji ve İmmünoloji Polikliniği'ne başvuran 30 ARK hastası ve 30 sağlıklı kontrol dahil edildi. OKT taramaları, gelişmiş derinlik görüntüleme (EDI) modunda Cirrus HD OCT-5000 (Carl Zeiss, Jena, Almanya) ile ölçüldü. Bulgular: Çalışma popülasyonunun hasta grubunun %66,7'si (n=20), kontrol grubunun %56,6'sı (n=17) kadındı. Ortalama yaş hasta ve kontrol gruplarında sırasıyla 13±2,3 ve 13,9±1,8 yıldı. Astımlı ARK hastalarında temporal subfoveal koroid kalınlığı istatistiksel olarak anlamlı derecede daha inceydi (p=0,032). ARK'lı hastalarda minimum ganglion hücre-iç pleksiform tabaka (GCIPL) kalınlığı ile mutlak eozinofil sayısı arasında güçlü bir negatif korelasyon bulundu (r:-0,551, p<0,0001). Sonuç: Çalışmamızda ARK hastalarında GCIPL kalınlığı daha düşüktü. Benzer şekilde astımlı hasta grubumuzda da minimum GCIPL kalınlığı istatistiksel anlamlı bulunmasa da astımı olmayanlara göre daha düşüktü. Sonuçlarımız çoklu alerjen duyarlılığının ve yüksek eozinofillerin GCIPL kalınlığını etkileyebileceğini göstermektedir. Ancak kronik takip sırasında hem koroid hem de retina dokusu etkilenebilir. Bu bulguları desteklemek için daha ileri çalışmalara ihtiyaç vardır.

Keywords

• Retina
• alerji
• rinit
• koroid

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