Alerjik rinokonjonktivitli hastalarda koroid ve retina değişiklikleri

Yıl 2024, Cilt: 17 Sayı: 4, 734 - 744, 09.10.2024

Ömer Akçal , Matin Suleymanzade , Burcu Işık , Mehmet Giray Ersöz

https://doi.org/10.31362/patd.1483135

Öz

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.

Anahtar Kelimeler

Retina, alerji, rinit, koroid

Choroidal and retinal changes in patients with allergic rhinoconjunctivitis

Öz

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.

Anahtar Kelimeler

Retina, allergy, rinitis, choroid

Kaynakça

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