1
|
Evereklioglu C, Er Arslantas E, Sener H, Akkul Z, Gahramanov K, Gulmez Sevim D, Polat OA, Horozoglu F. Effect of adalimumab on choroidal thickness and choroidal vascularity index in eyes with non-infectious uveitis using enhanced-depth imaging optical coherence tomography. Eye (Lond) 2024; 38:1633-1641. [PMID: 38378895 PMCID: PMC11156944 DOI: 10.1038/s41433-024-02975-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 01/15/2024] [Accepted: 01/29/2024] [Indexed: 02/22/2024] Open
Abstract
OBJECTIVE To evaluate the effect of adalimumab (ADA) on choroidal thickness (ChT) and choroidal vascularity index (CVI) in eyes with non-infectious uveitis (NIU). METHODS Thirty-seven eyes with NIU including Behçet disease (BD), sarcoidosis, ankylosing spondylitis (AS), juvenile idiopathic arthritis and idiopathic arthritis, 38 eyes of non-uveitic (NU) patients including BD, AS and rheumatoid arthritis, and 40 healthy control eyes were included. ADA was used for anti-TNF-naive adult (80 mg) or paediatric (40 mg) patients with refractory NIU, then 40 mg every 2-week (20 mg in children<30 kg) with controls at weeks 1, 4, 12, and 24. Images were used to measure central, nasal, and temporal ChT, and the luminal area (LA), stromal area, and total choroidal area (TCA) were analysed using enhanced-depth imaging optical coherence tomography (EDI-OCT) by ImageJ software. The CVI was then calculated as the ratio of LA to TCA. RESULTS Mean ages were similar between the groups. Mean (SE) subfoveal ChT measurements for each location were also similar (for each, p > 0.05). However, calculated CVI values in eyes with NIU (0.63 ± 0.007) were significantly (p < 0.001) lower than NU eyes (0.66 ± 0.006) and controls (0.70 ± 0.007) (p < 0.001). Moreover, CVI was significantly lower in NU eyes compared to controls (p < 0.001). There were no significant CVI changes between the consecutive visits after ADA therapy in eyes with NIU (for each, p > 0.05). CONCLUSIONS Decreased CVI in NIU and NU eyes indicates that systemic inflammation affects the choroidal vasculature and perfusion both in the presence and absence of ocular involvement. Although CVI may be used as a possible novel tool in monitoring ocular involvement and progression of NIU, CVI does not seem to be a biomarker for treatment monitoring in NIU.
Collapse
Affiliation(s)
- Cem Evereklioglu
- Department of Ophthalmology, Division of Uvea-Behçet Unit, Erciyes University Medical Faculty, Kayseri, Türkiye.
| | - Elif Er Arslantas
- Department of Ophthalmology, Division of Uvea-Behçet Unit, Erciyes University Medical Faculty, Kayseri, Türkiye
| | - Hidayet Sener
- Department of Ophthalmology, Division of Uvea-Behçet Unit, Erciyes University Medical Faculty, Kayseri, Türkiye
| | - Zeynep Akkul
- Department of Ophthalmology, Division of Uvea-Behçet Unit, Erciyes University Medical Faculty, Kayseri, Türkiye
| | - Kamran Gahramanov
- Department of Ophthalmology, Division of Uvea-Behçet Unit, Erciyes University Medical Faculty, Kayseri, Türkiye
| | - Duygu Gulmez Sevim
- Department of Ophthalmology, Division of Uvea-Behçet Unit, Erciyes University Medical Faculty, Kayseri, Türkiye
| | - Osman Ahmet Polat
- Department of Ophthalmology, Division of Uvea-Behçet Unit, Erciyes University Medical Faculty, Kayseri, Türkiye
| | - Fatih Horozoglu
- Department of Ophthalmology, Division of Uvea-Behçet Unit, Erciyes University Medical Faculty, Kayseri, Türkiye
| |
Collapse
|
2
|
Ruiz-Cruz M, Navarro-López P, Hernández-Valero GM, Concha-Del-Rio LE. Simultaneous evaluation of iris area and subfoveal choroidal thickness in Fuchs uveitis syndrome. BMC Ophthalmol 2024; 24:27. [PMID: 38243196 PMCID: PMC10799473 DOI: 10.1186/s12886-024-03304-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 01/16/2024] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND/AIMS To simultaneously evaluate iris area (IA) and subfoveal choroidal thickness (SFCT) in eyes with Fuchs Uveitis Syndrome (FUS). METHODS We prospectively recruited a case series of patients with FUS at our institution, simultaneously measuring IA with anterior segment spectral domain optical coherence tomography (SD-OCT) and SFCT with enhanced depth imaging optical coherence tomography (EDI-OCT). Iris images were analyzed by ImageJ software. We tested the differences in intereye IA and SFCT with the healthy eye (HE) using the Wilcoxon test, and clinical interpretation was controlled by intraclass correlation coefficient (ICC) between two masked specialists. RESULTS Sixteen patients with unilateral FUS were included. Six were female, and the age range was 37 to 67 (median age 48 years, IQR 41-60). ICC of 98.9%, with a lower confidence interval of 97%. Eyes with FUS had a significant thinning of the total iris median area (p < 0.002), restricted to the temporal and nasal areas compared to the HE (p < 0.01 and < 0.001, respectively). SFCT was also significantly thinner compared to the HE (p < 0.0001). A low correlation was found between iris and choroidal thinning in FUS eyes (rs = 0.21; p = 0.4). CONCLUSIONS This study found reduced iris area and subfoveal choroidal thickness in eyes with FUS compared to the normal fellow eye.
Collapse
Affiliation(s)
- Matilde Ruiz-Cruz
- Inflammatory Eye Disease Clinic. Asociación para Evitar la Ceguera en México, Vicente Garcia Torres No. 46 Coyoacán, Mexico City, 04030, Mexico
| | - Patricia Navarro-López
- Inflammatory Eye Disease Clinic. Asociación para Evitar la Ceguera en México, Vicente Garcia Torres No. 46 Coyoacán, Mexico City, 04030, Mexico
| | | | - Luz Elena Concha-Del-Rio
- Inflammatory Eye Disease Clinic. Asociación para Evitar la Ceguera en México, Vicente Garcia Torres No. 46 Coyoacán, Mexico City, 04030, Mexico.
| |
Collapse
|
3
|
Evereklioglu C, Polat OA, Gulmez Sevim D, Gahramanov K, Sener H, Sonmez HK, Arda H, Er Arslantas E, Horozoglu F. Choroidal vascularity index and submacular choroidal thickness in patients with Behçet disease assessed with enhanced-depth OCT. CANADIAN JOURNAL OF OPHTHALMOLOGY 2023:S0008-4182(23)00274-0. [PMID: 37748755 DOI: 10.1016/j.jcjo.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/02/2023] [Accepted: 09/01/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE To investigate changes in the choroid using the choroidal vascularity index (CVI) and choroidal thickness (ChT) in patients with ocular (OBD) and non-ocular Behçet disease (non-ocular BD). METHODS Sixty-eight OBD patients, 40 non-ocular BD patients, and 40 healthy control subjects were included. ChT was measured using optical coherence tomography (OCT) in enhanced-depth imaging (EDI) mode (EDI-OCT; sub-foveal ChT at 1000 μm, nasal ChT at 1000 μm temporal ChT). The CVI value (%) was calculated by dividing the luminal area by the sub-foveal total choroidal area. RESULTS The mean sub-foveal ChT (297 ± 68 µm), nasal ChT (261 ± 66 µm), and temporal ChT (272 ± 68 µm) in eyes with OBD and the mean sub-foveal ChT (286 ± 31 µm), nasal ChT (266 ± 29 µm), and temporal ChT (269 ± 32 µm) in eyes with non-ocular BD were significantly decreased compared with those regions in healthy control subjects (333 ± 69, 301 ± 75, and 312 ± 70 µm, respectively). Additional subgroup analysis was performed for active OBD, inactive OBD, non-ocular BD, and the control group, and in pairwise comparisons, the CVI value was significantly decreased in both active (64.3 ± 3.1) and inactive OBD groups (64.2 ± 4.5) compared with healthy control subjects (67.2 ± 3.6; p = 0.026 and p < 0.001, respectively). There was no significant difference between non-ocular BD (65.9 ± 3.4) and control subjects (67.2 ± 3.6) for CVI measurements (p > 0.05). CONCLUSIONS Decreased CVI values in OBD suggest that uveitis affects the choroidal vasculature and that perfusion is affected by uveitis, whereas systemic inflammation in non-ocular BD does not affect them. In addition, the choroid in uveitis is affected by the chronicity of the disease rather than disease activity. ChT measurements and CVI values may be a novel and robust prognosticating biomarker to evaluate choroidal vasculature and to monitor disease progression in OBD patients because EDI-OCT is a non-invasive imaging modality. However, CVI does not seem to be a biomarker for monitoring of disease activity or treatment efficacy.
Collapse
Affiliation(s)
- Cem Evereklioglu
- Department of Ophthalmology, Division of Uvea-Behçet Unit, Erciyes University Medical Faculty, Kayseri, Türkiye.
| | - Osman Ahmet Polat
- Department of Ophthalmology, Division of Uvea-Behçet Unit, Erciyes University Medical Faculty, Kayseri, Türkiye
| | - Duygu Gulmez Sevim
- Department of Ophthalmology, Division of Uvea-Behçet Unit, Erciyes University Medical Faculty, Kayseri, Türkiye
| | - Kamran Gahramanov
- Department of Ophthalmology, Division of Uvea-Behçet Unit, Erciyes University Medical Faculty, Kayseri, Türkiye
| | - Hidayet Sener
- Department of Ophthalmology, Division of Uvea-Behçet Unit, Erciyes University Medical Faculty, Kayseri, Türkiye
| | - Hatice Kubra Sonmez
- Department of Ophthalmology, Division of Uvea-Behçet Unit, Erciyes University Medical Faculty, Kayseri, Türkiye
| | - Hatice Arda
- Department of Ophthalmology, Division of Uvea-Behçet Unit, Erciyes University Medical Faculty, Kayseri, Türkiye
| | - Elif Er Arslantas
- Department of Ophthalmology, Division of Uvea-Behçet Unit, Erciyes University Medical Faculty, Kayseri, Türkiye
| | - Fatih Horozoglu
- Department of Ophthalmology, Division of Uvea-Behçet Unit, Erciyes University Medical Faculty, Kayseri, Türkiye
| |
Collapse
|
4
|
Comparison of retinal and choroidal changes in Fuchs’ uveitis syndrome. Int Ophthalmol 2022; 43:1957-1965. [DOI: 10.1007/s10792-022-02595-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 11/12/2022] [Indexed: 12/03/2022]
|
5
|
Zhou FY, Li YS, Guo X, Shi X, Wu K, Zheng JW, Li XX, Wu J, Liu R, Dai ML, Huang XF, Hou F, Lin D, Wang YQ. Contrast Sensitivity Deficits and Its Structural Correlates in Fuchs Uveitis Syndrome. Front Med (Lausanne) 2022; 9:850435. [PMID: 35665328 PMCID: PMC9160426 DOI: 10.3389/fmed.2022.850435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose To investigate the deficits in contrast sensitivity in patients with Fuchs uveitis syndrome (FUS) and to explore the potential relationship between contrast sensitivity and ocular structure. Methods In this prospective study, 25 patients with FUS and 30 healthy volunteers were recruited. Eyes were divided into three groups: FUS-affected eyes (AE), fellow eyes (FE), and healthy eyes. The contrast sensitivity function (CSF) of all participants was evaluated using the quick CSF (qCSF) method. Fundus photographs were collected for the analysis of refractive media, and vascular density (VD) was assessed using optical coherence tomography angiography (OCTA). Data were analyzed and compared using the generalized estimating equation (GEE). Results The CSF of AE was significantly lower than that of FE and controls, while no significant difference was observed between FE and controls. Contrast sensitivity was negatively correlated with the grade of haze. No significant correlation was found between visual function and VDs in FUS eyes. Conclusions We found that the CSF of FUS-affected eyes was significantly reduced, and the visual impairment was predominantly caused by the refractive media turbidity.
Collapse
Affiliation(s)
- Fang-Yue Zhou
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yi-Sha Li
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Xingneng Guo
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Xiutong Shi
- School of Optometry, Tianjin Vocational Institute, Tianjin, China
| | - Ke Wu
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Jing-Wei Zheng
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Xia-Xin Li
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Jiaqing Wu
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Ruru Liu
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Ma-Li Dai
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Xiu-Feng Huang
- The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, China
- Wenzhou Medical University-Monash BDI Alliance in Clinical and Experimental Biomedicine, Wenzhou Medical University, Wenzhou, China
| | - Fang Hou
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Dan Lin
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
- *Correspondence: Dan Lin
| | - Yu-Qin Wang
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
- Yu-Qin Wang
| |
Collapse
|
6
|
Yılmaz M, Polat OA, Karayiğit DZ, Ayyıldız T. Choroidal vascularity index and choroidal thickness changes in patients with allergic asthma. Photodiagnosis Photodyn Ther 2021; 36:102494. [PMID: 34450328 DOI: 10.1016/j.pdpdt.2021.102494] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 08/19/2021] [Accepted: 08/19/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND This study aimed to investigate whether the choroidal vascularity index (CVI), choroidal thickness (ChT), and retinal nerve fiber thickness (RNFL) of patients with allergic asthma change compared to the healthy control group. METHODS This cross-sectional, observational study comprised 59 eyes of 59 patients with allergic asthma (Group 1) and 50 eyes of 50 age and sex-matched healthy volunteers as a control group (Group 2). CVI was measured by binarization of images obtained from choroidal enhanced depth imaging (EDI) mode optic coherence tomography. CVI was defined as the ratio of the choroidal luminal area to the total circumscribed choroidal area. ChT was measured manually at 3 points, subfoveal and 1000 microns nasal and temporal to the fovea (SFCT, N1000, and T1000 respectively). RNFL measurements were subdivided as global, nasal, temporal, superonasal, superotemporal, inferonasal, and inferotemporal quadrants. RESULTS Subfoveal CVI and ChT were significantly lower in asthma patients (p:0,043 and p: 0.034, respectively). N1000 and T1000 ChT and RNFL thicknesses were lower in asthma patients compared to the control group, though no significant difference was found between them (p> 0.05). CONCLUSION Our findings suggest that asthma patients have choroidal structural changes. In the literature, there are not enough studies regarding the effects of asthma on ocular parameters.
Collapse
Affiliation(s)
- Mevlüt Yılmaz
- Ulucanlar Eye Research and Training Hospital, Ophthalmology Department, 06100 Altındag, Ankara, Turkey.
| | - Osman Ahmet Polat
- Erciyes University Medical Faculty Ophthalmology Department Kayseri, Turkey
| | - Duygu Zorlu Karayiğit
- Ahi Evran University Medical Faculty, Department of Pulmonary Diseases Kırşehir, Turkey
| | - Taha Ayyıldız
- Bursa City Hospital, Ophthalmology Department, Bursa, Turkey
| |
Collapse
|