Retinal nerve fibre layer thickness and choroidal thickness: An evaluation in psoriasis patients

Evaluation of the retinal nerve fiber layer and choroidal thickness with optical coherence tomography in patients with psoriasis

BACKGROUND

To evaluate the retinal nerve fiber layer (RNFL), central retinal thickness (CRT), and choroidal thickness (CT) in patients with psoriasis.

METHODS

The study included 43 patients diagnosed with psoriasis not receiving systemic treatment and 41 healthy volunteers. Spectral domain optical coherence tomography was used for retinal and choroidal thickness measurements. The mean RNFL, quadrant RNFL (superior, inferior, nasal, temporal), and CRT values were recorded. The choroidal thickness measurements were taken from the subfoveal area, towards the temporal and nasal directions from the fovea at distances of 500, 1000, and 1500 µm.

RESULTS

The RNFL was determined to be thinner in the superior quadrant (p=0.025), and the CT was thicker at all the measurement points (p < 0.05) in the patients with psoriasis. The CRT values were similar in both groups (p > 0.05). No correlation was determined between the parameters measured and disease duration or severity.

CONCLUSIONS

Thinning of the RNFL and increased CT may be a sign of choroidal microvascular changes and ganglion cell damage due to psoriasis.

Identifying and Treating Ocular Manifestations in Psoriasis

Psoriasis is a chronic immune-mediated inflammatory skin condition that commonly presents with red, thickened, and scaling plaques. Given the prominent cutaneous manifestations of psoriasis, more subtle ophthalmic findings of the disease may initially go undetected, with the potential for significant ocular morbidity. Associated ocular disease can involve nearly any structure of the eye, with the eyelids most commonly being affected, resulting in relatively common signs and symptoms of ocular surface discomfort. The presence of intraocular inflammation (i.e., uveitis) or retinal involvement carry a heightened risk of vision loss, and are often more difficult to diagnose outside of the ophthalmology clinic. Early detection and treatment of ocular disease can limit morbidity and are critical to the management of these patients, which requires coordination of care between dermatologists and ophthalmologists. The objective of this article was to review the most common ocular conditions that affect psoriatic patients, when to consider referral to an ophthalmologist, and to summarize the adverse ocular effects of current psoriasis treatments.

Assessment of central retinal thickness, choroidal thickness, and retinal nerve fiber layer in psoriasis: a spectral-domain optical coherence tomography study

Background

This study aims to evaluate choroidal thickness (CT), retinal thickness, ganglion cell-inner plexiform layer (GCIPL), and retinal nerve fiber layer (RNFL) structures in psoriasis patients using optical coherence tomography (OCT).

Methods

This study included 33 psoriasis patients and 33 healthy individuals. Moreover, psoriasis patients who did not use any systemic anti-inflammatory treatment were evaluated. Retinal and choroidal images of the participants were obtained with spectral-domain OCT. Furthermore, CT was measured in the subfoveal, temporal, and nasal positions at 500-µm intervals to a distance of 1,500 μm from the foveal center.

Results

The mean psoriasis area and severity index (PASI) score was 5.70 (range, 2.40–9.00). No significant differences were found in subfoveal (p = 0.659), temporal, and nasal CT values in psoriasis patients compared with the control group (p > 0.05). Similarly, no statistically significant differences were found between the groups in terms of central retinal thickness, macular GCIPL, and RNFL (p > 0.05). Moreover, no significant correlation exists between the duration of psoriasis disease and PASI scores and OCT parameters (p > 0.05).

Conclusions

No significant changes in CT, ganglion cell layer, RNFL, and retinal thickness values were noted in psoriasis patients with mild to moderate mean PASI score.