Choroidal thickness changes in connective tissue diseases

Öz

 

Purpose: To evaluate choroidal thickness (CT) changes in connective tissue disease (CTD) using spectral domain optical coherence tomography (SD OCT) with enhanced depth imaging (EDI).

Methods:   In this prospective clinical study, we included 34 subjects who were diagnosed as CTD in remission for at least  3 month and 30 age- and gender-matched healthy controls. Central macular thickness (CMT), subfoveal CT, and CT at nasal (N) and temporal (T) distances of 500 μm (N500 and T500, respectively) and 1500 μm (N500 and T1500, respectively) from the central fovea were measured by EDI OCT  .

Results:  The mean CMT of the patient group (219.2 μm) was thinner compared to the control group (225.5 μm), but the difference was not statistically significant (p = 0.2). At the same time  Mean CT values were thinner  at all measure points in the CTD subjects.  The mean subfoveal CT,N500, N1500, T500and T1500  were not significantly different in comparison to controls (all p>0.05). 

Conclusions: Although our results did not reach statistical significance, we found thinner choroidal tissue  in patients with CTD .

Keywords:Choroidal thickness, connective tissue diseases  

Bağ dokusu hastalıklarında koroidal kalınlık değişikleri

Öz

Amaç: Çalışmanın amacı bağ dokusu hastalıklarında (BDH) koroid kalınlığı (KK) değişikliklerinin Spektral Domein optik koherens tomografi (SD OKT) kullanılarak değerlendirilmesidir.Gereç ve Yöntemler: Bu prospektif klinik çalışmada, en az 3 aydır remisyonda olan ve bağ dokusu hastalığı tanısı almış 34 hasta ve yaş ve cinsiyet uyumu olan 30 sağlam kişi kontrol grubu olarak değerlendirilmiştir. Santral makula kalınlığı (SMK) subfoveal, nazal ve temporal 500, 1500 mikron mesafelerdeki KK, SD OKT ile ölçülmüştür.Bulgular: Hasta grubunda ortalama SMK (219,2 μm) kontrol grubuna göre (225,5 μm) daha ince bulunmuştur. Ancak aradaki fark istatistiksel olarak anlamlı değildi (P = 0,2). Aynı zamanda ortalama KK her ölçüm noktası için hasta grubunda incelmiş olarak bulunmuştur fakat aradaki fark yine istatistiksel olarak anlamlı değildi (P > 0,05). Sonuçlar: İstatistiksel olarak anlamlı olmamasına rağmen BDH’larında koroid dokusu kalınlığı incelmiş olarak bulunmuştur

Anahtar Kelimeler

• Optik koherens tomografi, göz hastalıkları, bağ dokusu hastalıkları, koroidal hastalıklar, klinik çalışma

Kaynakça

1. Farkas TG, Sylvester V, Archer D. The choroidopathy of progressive systemic sclerosis (scleroderma). Am J Ophthalmol 1972; 74: 875-86.
2. Serup L, Serup J, Hagdrup H. Fundus fluorescein angiography in generalized scleroderma. Ophthalmic Res 1987; 19: 303-8.
3. Allanore Y, Parc C, Monnet D, Brézin AP, Kahan A. Increased prevalence of ocular glaucomatous abnormalities in systemic sclerosis. Ann Rheum Dis 2004; 63: 1276-8.
4. Božić M, Senćanić PH, Spahić G, et al. Is nail fold capillaroscopy useful in normotensive and primary open angle glaucoma? A pilot study. Curr Eye Res 2010; 35: 1099-104.
5. Park HY, Park SH, Oh YS, Park CK. Nail bed hemorrhage: a clinical marker of optic disc hemorrhage in patients with glaucoma. Arch Ophthalmol 2011; 129: 1299-304.
6. Ushiyama O, Ushiyama K, Yamada T, et al. Retinal findings in systemic sclerosis: a comparison with nailfold capillaroscopic patterns. Ann Rheum Dis 2003; 62: 204-7.
7. Parver LM. Temperature modulating action of choroidal blood flow. Eye 1991; 5: 181-5.
8. Cao J, McLeod S, Merges CA, et al. Choriocapillaris degeneration and related pathologic changes in human diabetic eyes. Arch Ophthalmol1998; 116: 589-97.

9. Nickla DL, Wallman J. The multifunctional choroid. Prog Retin Eye Res. 2010; 29: 144-68.
10. Spaide RF, Koizumi H, Pozzoni MC. Enhanced depth imaging spectral-domain optical coherence tomography. Am J Ophthalmol 2008; 146: 496-500.
11. Ikuno Y, Kawaguchi K, Nouchi T, et al. Choroidal thickness in healthy Japanese subjects. Invest Ophthalmol Vis Sci 2010; 51: 2173-6.
12. Manjunath V, Taha M, Fujimoto JG et al. Choroidal thickness in normal eyes measured using Cirrus HD optical coherence tomography. Am J Ophthalmol 2010; 150: 325-9.
13. Margolis R, Spaide RF. A pilot study of enhanced depth imaging optical coherence tomography of the choroid in normal eyes. Am J Ophthalmol 2009; 147: 811-5.
14. Ikuno Y, Kawaguchi K, Nouchi T, Yasuno Y. Choroidal thickness in healthy Japanese subjects. Invest Ophthalmol Vis Sci 2010; 51: 2173-6.
15. Agawa T, Miura M, Ikuno Y, et al. Choroidal thickness measurement in healthy Japanese subjects by three-dimensional high- penetration optical coherence tomography. Graefes Arch 2011; 249: 1485-92.
16. Brown JS, Flitcroft DI, Ying GS, et al. In vivo human choroidal thickness measurements: evidence for diurnal fluctuations. Invest Ophthalmol Vis Sci 2009; 50: 5-12.
17. Reiner A, Li C, Del Mar N, Fitzgerald ME. Choroidal blood flow compensation in rats for arterial blood pressure decreases is neuronal nitric oxide-dependent but compensation for arterial blood pressure increases is not. Exp Eye Res 2010; 90: 734-41.
18. Kiel JW. Choroidal myogenic autoregulation and intraocular pressure. Exp Eye Res 1994; 58: 529-43.
19. Tanabe H, Ito Y, Iguchi Y, Ozawa S, Ishikawa K, Terasaki H. Correlation between cross-sectional shape of choroidal veins and choroidal thickness. Jpn J Ophthalmol 2011; 55: 614-9.
20. Vance SK, Imamura Y, Freund KB. The effects of sildenafil citrate on choroidal thickness as determined by enhanced depth imaging optical coherence tomography. Retina 2011; 31: 332-5.
21. Wong IY, Wong RL, Zhao P, Lai WW. Choroidal thickness in relation to hypercholesterolemia on enhanced depth imaging optical coherence tomography. Retina 2013; 33: 423-8.
22. Regatieri CV, Branchini L, Carmody J, et al. Choroidal thickness in patients with diabetic retinopathy analyzed by spectral-domain optical coherence tomography. Retina 2012; 32: 563-8.
23. Ayton LN, Guymer RH, Luu CD. Choroidal thickness profiles in retinitis pigmentosa. Clin Experiment Ophthalmol 2013; 41: 396-403.
24. Ingegnoli F, Gualtierotti R, Pierro L, et al. ACUTE study group; ACUTE study group. Choroidal impairment and macular thinning in patients with systemic sclerosis: the acute study. Microvasc Res 2015; 97: 31-6.
25. Grennan DM, Forrester J. Involvement of the eye in SLE and scleroderma. A study using fluorescein angiography in addition to clinical ophthalmic assessment. Ann Rheum Dis 1977; 36: 152-6.
26. Tailor R, Gupta A, Herrick A, Kwartz J. Ocular manifestations of scleroderma. Surv Ophthalmol 2009; 54: 292-304.
27. Kola M, Kalkisim A, Karkucak M, et al. Evaluation of choroidal thickness in ankylosing spondylitis using optical coherence tomography. Ocul Immunol Inflamm 2014; 22: 43-8.
28. Duru N, Altinkaynak H, Erten Ş, et al. Thinning of choroidal thickness in patients with rheumatoid arthritis unrelated to disease activity. Ocul Immunol Inflamm 2016; 24: 246-53.
29. Altinkaynak H, Duru N, Uysal BS, et al. Choroidal thickness in patients with systemic lupus erythematosus analyzed by spectral-domain optical coherence tomography. Ocul Immunol Inflamm 2015; 8: 1-7.