Sigara İçmeyi Bırakan Hastalarda Koroid Kalınlığı Değişiklikleri

Yıl 2018, Cilt: 4 Sayı: 3, 283 - 288, 01.01.2018

Fulya Duman Kemal Kiraz Deniz Turgut Çoban Elçin Süren Muhammed Kazım Erol

Öz

Amaç: Sigara kullanımının ve bırakmanın koroid kalınlığına ve dolayısıyla retinanın kanlanmasına etkisini göstermek.Gereç ve Yöntemler: Sigara Bırakma Kliniğine başvuran, en az on yıldır sigara kullanıp bırakabilen ve göz patolojisi bulunmayan hastalar çalışmaya alındı. Hastaların demografik ve klinik özellikleri prospektif olarak incelendi ve kaydedildi. Hastaların oftalmolojik muayene bulguları ve sigara içmeyi bırakmadan önceki, bir hafta ve bir ay sonraki subfoveal koroidal kalınlık SFKK değerleri kaydedildi. Sonuçlar Kolmogorov-Smirnov testi ile hesaplanıp Student t ve Mann-Whitney U testleri ile analiz edildi.Bulgular: Çalışmaya 113 hasta alındı ancak 78’i sigarayı bırakamadığı veya kontrollere gelmediği için çalışmadan çıkarıldı. Çalışmaya dahil olan toplam 35 hastanın 70 gözü değerlendirmeye alındı. Hastaların 15’i kadın %42,9 , 20’si erkek %57,1 , yaş ortalamaları 49,43 idi. Gözlerin aksiyel uzunlukları ortalama 22,49 mm olarak bulundu. Hastaların ilk muayenede SFKK1=231,51µm , sigarayı bıraktıktan sonraki birinci hafta SFKK2=236,54µm ve birinci aydaki SFKK3=234,87µm ortalama SFKK’ları karşılaştırıldığında üç ölçüm arasında anlamlı fark olduğu görüldü p

Anahtar Kelimeler

Koroid kalınlığı, Optik Koherens tomografi, Sigara kullanımı

Changes in Choroidal Thickness in Patients who Stop Smoking

Öz

Objective: To denote the effect of smoking and cessation of smoking on choroidal thickness and hence retinal blood flow. Material and Methods: Patients who were referred to the Smoking Cessation Clinic, who used to smoke for at least ten years and then quit, and with no ocular pathology were included in the study. Demographic and clinical aspects of the patients were analyzed and recorded. Ophthalmological findings and values of subfoveal choroidal thickness SFCT before and one week and one month after cessation of smoking were recorded. Results were calculated with the Kolmogorov-Smirnov test and analyzed using the Student t and Mann-Whitney U tests.Results: We had to exclude 78 of the original 113 patients as they were unable to stop smoking or did not come for follow up. Seventy eyes of the 35 included patients were analyzed. Fifteen 42.9% patients were female and 20 57.1% were male and the mean age was 49.43 years. Mean axial length was found to be 22.49 mm. When mean SFCTs at the first examination SFCT1=231.51µm and at the first week SFCT2=234.87µm and first month SFCT3=234.87µm after cessation of smoking were compared, the difference between these three parameters was found to be significant p

Anahtar Kelimeler

Choroidal thickness, Optic Coherence tomography, Smoking

Kaynakça

• 1. Honda T, Fujimoto K, Miyao Y, Koga H, Ishii M. Current cigarette smoking is an independent risk factor for subacute stent thrombosisin acute myocardial infarction patients. J Cardiol 2014;63:358-64.
• 2. Huttunen R, Heikkinen T, Syrjänen J. Smoking and the outcome of infection. Journal of Internal Med 2011;269(3):258-69.
• 3. Asfar T, Lam BL, Lee DJ. Smoking causes blindness: time for eye care professionals to join the fight against tobacco. Invest Ophthal & Vis Sci 2015;56(2):1120-1.
• 4. Sigler EJ, Randolph JC, Calzada JI, Charles S. Smoking and choroidal thickness in patients over 65 with earlyatrophic age-related macular degeneration and normals. Eye 2014;28:838-46.
• 5. Kolar P. Risk factors for central and branch retinal vein occlusion: A meta-analysis of published clinical data. J Ophthalmol 2014;2014:724780.
• 6. Akarsu M, Abit MA, İlhan Ö. Sigara içenlerde retinal sinir lifi kalınlığının optik koherens tomografi ile değerlendirilmesi. Retina-Vitreus 2015;23(2):137-40.
• 7. Lee SW, Yu SY, Seo KH, Kim ES, Kwak HW. Diurnal variation in choroidal thickness in relation to sex, axial length, and baseline choroidal thickness in healthy Korean subjects. Retina 2014;34:385-93.
• 8. Osmanbaşoğlu OA, Alkın Z, Özkaya A, Özpınar Y, Yazıcı AT, Demirok A. Diurnal choroidal thickness changes in normal eyes of Turkish people measured by spectral domain optical coherence tomography. J Ophthalmol 2013;2013:687165.
• 9. Colombo L, Sala B, Montesano G, Pierrottet C, De Cillà S, Maltese P, Bertelli M, Rossetti L. Choroidal thickness analysis in patients with Usher Syndrome type 2 using EDI OCT. J Ophthalmol 2015;2015:189140.
• 10. Kabasawa S, Mori K, Horie-Inoue K, GehlbachPL, Inoue S, Awata T, Katayama S, Yoneya Sl. Associations of cigarette smoking but not serum fatty acids with agerelated macular degeneration in a Japanese population. Ophthalmol 2011;118(6):1082-8.
• 11. Kim SW, Oh J, Kwon SS, Yoo J, Huh K. Comparison of choroidal thickness among patients with healthy eyes, early age related maculopathy, neovascular age related macular degeneration, central serous chorioretinopathy, and polypoidal choroidal vasculopathy. Retina 2011;31(9):1904-11.
• 12. Cackett P, Yeo I, Cheung CM, Vithana EN, Wong D, Tay WT, Tai ES, Aung T, Wong TY. Relationship of smoking and cardiovascular risk factors with polypoidal choroidal vasculopathy and age-related macular degeneration in Chinese persons. Ophthalmol 2011;118(5):846-52.
• 13. Chung SE, Kang SW, Lee JII, Kim YT. Choroidal thickness in polypoidal choroidal vasculopathy and exudative age-related macular degeneration. Ophthalmol 2011;118(5):840-5.
• 14. Chheda LV, Ferketich AK, Carroll CP, Moyer PD, Kurz DE, Kurz PA. Smoking as a risk factor for choroidal neovascularization secondary to presumed ocular histoplasmosis syndrome. Ophthalmol 2012;119(2):333- 8.
• 15. Wimpissinger B, Resch H, Berisha F, Weigert G, Polak K, Schmetterer L. Effects of isometric exercise on subfoveal choroidal blood flow in smokers and nonsmokers. Invest Ophthalmol Vis Sci 2003;44:4859-63.
• 16. Sızmaz S, Küçükerdönmez C, Pınarcı EY, Karalezli A, Canan H, Yılmaz G. The effect of smoking on choroidal thickness measured by optical coherence tomography. Br J Ophthalmol 2013;97(5):601-4.
• 17. Kantarcı F, Tatar MG, Colak HN, Uslu H, Yıldırım A, Goker H, Gurler B, Karaca EE. A pilot study of choroidal thickness in long-term smokers. Retina 2016;36:986-91.
• 18. Wei WB, Xu L, Jonas JB, Shao L, Du KF, Wang S Chen CX, Xu J, Wang YX, Zhou JQ, You QS. Subfoveal choroidal thickness: The Beijing eye study. Ophthalmol 2013;120(1):175-80.
• 19. Tan CS, Ouyang Y, Ruiz H, Sadda SR. Diurnal variation of choroidal thickness in normal, healthy subjects measured by spectral domain optic coherence tomography. Invest Ophthalmol Vis Sci 2012;53(1):261-6.
• 20. Tamaki Y, Araje M, Nagahara M, Tomita K. Acute effect of cigarette smoking on tissue circulation in human optic nerve head and choroid-retina. Ophthalmol 1999;106:564-9.
• 21. Brown JS, Flitcroft DI, Ying G, Francis EL, Schmid GF, Quinn GE, Stone RA. In vivo human choroidal thickness measurements: Evidence for diurnal fluctuations. Invest Ophthalmol Vis Sci 2009;50(1):5-12.
• 22. Chakraborty R, Read SA, Collins MJ. Diurnal variations in axial length, choroidal thickness, intraocular pressure, and ocular biometrics. Invest Ophthalmol Vis Sci 2011;52:5121-9.
• 23. Gök M, Ozdemir O. Effect of topiramate on choroidal thickness and anterior chamber parameters in the treatment of patients with migraine. Cutan Ocul Toxicol 2017;36(4):381-6.
• 24. Manjunath V, Taha M, Fujimoto JG, Duker JS. Choroidal thickness in normal eyes measured using Cirrus HD optical coherence tomography. Am J Ophthalmol 2010;150:325-9.
• 25. Ferreira JT, Vicente A, Proença R, Santos BO, Cunha JP, Alves M, Papoila AL, Pinto LA. Choroidal thickness in diabetic patients without diabetic retinopathy. Retina 2018;38(4):795-804.
• 26. Ünsal E, Eltutar K, Zirtiloğlu S, Dinçer N, Erkul SÖ, Güngel H. Choroidal thickness in patients with diabetic retinopathy. Clin Ophthalmol 2014;27(8):637-42.