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Kivrak U, Köle MT, Küçük N, Akçay G. Comparison of posterior segment ocular parameters of Familial mediterranean fever with homozygous M694V mutation and carriers with heterozygous M694V mutation in children. Photodiagnosis Photodyn Ther 2023; 43:103680. [PMID: 37394084 DOI: 10.1016/j.pdpdt.2023.103680] [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: 04/24/2023] [Revised: 06/25/2023] [Accepted: 06/26/2023] [Indexed: 07/04/2023]
Abstract
PURPOSE The aim of this study is to comparatively evaluate the posterior segment ocular parameters of Familial Mediterranean fever (FMF) patients, asymptomatic FMF carriers, and the healthy controls in the pediatric age group. METHODS The study included 30 FMF patients with homozygous M694V mutation in remission under colchicine therapy, 12 asymptomatic FMF carriers with heterozygous M694V mutation, and 41 age-sex-matched healthy controls. All patients underwent detailed eye examination, and peripapillary retinal nerve fiber layer (pRNFL) thickness, central macular thickness (CMT), subfoveal choroidal thickness (SCT), macular vascular densities, and foveal avascular zone (FAZ) areas were measured using swept-source optical coherence tomography angiography. RESULTS In this study, the mean pRNFL thickness was statistically significantly thinner (p = 0.010) in the FMF patients group compared to the FMF carriers group and the healthy control group, especially in the inferior quadrant of pRNFL (p = 0.042). The CMT in asymptomatic FMF carriers group was statistically significantly thicker than in FMF patients group (p = 0.037), especially the superior and inferior quadrants of macula were affected (p = 0.024; p = 0.020, respectively). In addition, this study showed that the changes of pRNFL thickness and CMT in pediatric patients with FMF were moderately correlated with the duration of diagnosis. There was no significant difference between the groups in terms of macular vascular densities and FAZ values. CONCLUSION FMF is a hereditary autoinflammatory disease that causes multi-organ involvement, and this study showed that posterior segment ocular parameters could be affected not only in FMF patients but also in asymptomatic FMF carriers.
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Affiliation(s)
- Ulviye Kivrak
- University of Health Sciences, Kartal Dr. Lütfi Kırdar City Hospital, Department of Ophthalmology, İstanbul, Turkey; Istanbul University Institute Of Graduate Studies İn Health Sciences, Advanced Neurologıcal Scıences, İstanbul, Turkey.
| | - Mehmet Tolga Köle
- University of Health Sciences, Kartal Dr. Lütfi Kırdar City Hospital, Department of Pediatrics, İstanbul, Turkey
| | - Nuran Küçük
- University of Health Sciences, Kartal Dr. Lütfi Kırdar City Hospital, Department of Pediatric Nephrology, İstanbul, Turkey
| | - Güzide Akçay
- University of Health Sciences, Kartal Dr. Lütfi Kırdar City Hospital, Department of Ophthalmology, İstanbul, Turkey
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Balikoglu Yilmaz M, Doganay Kumcu N, Daldal H, Saritepe Imre S, Aydin E, Ozgul S, Kose T. May ganglion cell complex analysis be a marker for glaucoma susceptibility in unilateral Fuchs' uveitis syndrome? Graefes Arch Clin Exp Ophthalmol 2021; 259:1975-1983. [PMID: 33929589 DOI: 10.1007/s00417-021-05182-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/23/2021] [Accepted: 04/01/2021] [Indexed: 01/06/2023] Open
Abstract
PURPOSE To compare retinal nerve fiber layer (RNFL) thickness and ganglion cell-inner plexiform layer thickness (GCIPLT) in the affected eyes to fellow unaffected eyes of patients with unilateral Fuchs' uveitis syndrome (FUS) and analyze their change over time. METHODS Twenty seven unilateral FUS patients who did not have concomitant systemic or ocular disease were retrospectively enrolled. Central macular thickness (CMT), RNFL thickness, and GCIPLT measurements were evaluated. Data was analyzed using the non-parametric Brunner-Langer model (LD-F2 design) and Wilcoxon signed-rank test. RESULTS The mean age of the patients was 40.2 ± 10.2 years. The median disease duration was 11 (2-62) months. The median best-corrected visual acuity (BCVA) of the affected eyes and the fellow eyes was 0.22 (0.00-2.50) vs. 0.00 (0.0-0.10) logMAR at the initial visit and 0.05 (0.00-2.50) vs. 0.00 (0.0-0.30) logMAR at the final visit. The change in BCVA was found significant in the affected eyes, but not in the fellow eyes (p < 0.001 and p = 0.287, respectively). The median CMT in the affected eyes at the final visit was not statistically different from the value at the initial visit (255 (157-306) vs. 245 (140-310) µm, p = 0.256). The change in RNFL thickness over time in the affected eyes was similar to the fellow unaffected eyes of the patients with unilateral FUS at all quadrants, with non-significant time and group effects (p > 0.05). However, median GCIPLT in all quadrants (except superonasal) in the affected eyes was statistically lower than the fellow eyes at the initial and final visits (p < 0.05). The most affected quadrant of the ganglion cell complex was inferonasal in the involved eyes (79 (42-97) vs. 75 (43-87) µm) at initial and final visits (p = 0.033 for time effect and p < 0.001 for group effect, respectively). CONCLUSION Median CMT and RNFL thickness did not change during follow-up in the affected eyes of patients with unilateral FUS. Median GCIPLT in the affected eyes declined over time in all quadrants. Ganglion cell loss was also most prominent in the inferonasal quadrant in the affected eyes. FUS patients should be followed up long-term in terms of ganglion cell loss, especially in the inferonasal quadrant.
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Affiliation(s)
- Melike Balikoglu Yilmaz
- Ophthalmology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Basın Sitesi Mah, Hasan Tahsin Cad No: 143, 35150, Karabaglar, Izmir, Turkey.
| | | | - Hatice Daldal
- Ophthalmology, Training and Research Hospital, Usak University, Usak, Turkey
| | - Seher Saritepe Imre
- Ophthalmology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Basın Sitesi Mah, Hasan Tahsin Cad No: 143, 35150, Karabaglar, Izmir, Turkey
| | - Erdinc Aydin
- Ophthalmology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Basın Sitesi Mah, Hasan Tahsin Cad No: 143, 35150, Karabaglar, Izmir, Turkey
| | - Semiha Ozgul
- Department of Biostatistics and Medical Informatics, Ege University, Izmir, Turkey
| | - Timur Kose
- Department of Biostatistics and Medical Informatics, Ege University, Izmir, Turkey
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Karkucak M, Kola M, Kalkişim A, Çapkin E, Ayar A, Türk A. Infliximab therapy provides beneficial effects for choroidal thickness increase in patients with active ankylosing spondylitis: A possible mechanism mediating the suppressing of uveitis attacks. Arch Rheumatol 2020; 36:56-62. [PMID: 34046569 PMCID: PMC8140873 DOI: 10.46497/archrheumatol.2021.7806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 01/24/2020] [Indexed: 11/03/2022] Open
Abstract
Objectives This study aims to quantitatively assess the profile of the choroidal thickness (ChT) in patients with ankylosing spondylitis (AS) using optical coherence tomography (OCT), and to examine whether the posterior eye segment abnormalities in active AS patients are reversible by infliximab therapy. Patients and methods October 2014 and March 2016 Thirty-one patients with AS (22 males, 9 females; mean age 39.6±12.3 years; range, 22 to 68 years) and 24 healthy controls (16 males, 8 females; mean age 40.8±8.9 years; range, 35 to 61 years) were enrolled. Patients' clinical and demographic characteristics were recorded. Using OCT, we performed retinal nerve fiber layer (RNFL) thickness, ganglion cell complex, and ChT measurements in AS patients before and six months after the initiation of infliximab therapy, and in healthy controls. Results At baseline, patients with AS had higher ChT (mean±standard deviation: 347.5±114.4 μm) compared to healthy controls (322.1±62.8 μm), although this did not reach statistical significance level (p=0.283). At six months after the first measurement, the mean ChT was significantly decreased (under infliximab therapy: 326.5±99.7 μm vs. before: 347.5±114.4 μm, p=0.018) in AS group, while no significant change was observed in the control group (p=0.102). RNFL thickness in the AS group was significantly decreased after six months of treatment with infliximab (p=0.008). Conclusion By evaluating the posterior eye segment of patients with AS using OCT, this study has demonstrated that active AS patients had higher ChT. The significant reduction in this ChT after infliximab therapy may be mediating the established effective suppressing action of infliximab on uveitis attacks.
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Affiliation(s)
- Murat Karkucak
- Department of Orthopedics and Traumatology, Karadeniz Technical University Medical School, Trabzon, Turkey
| | - Mehmet Kola
- Department of Ophthalmology, Karadeniz Technical University Medical School, Trabzon, Turkey
| | - Ahmet Kalkişim
- Department of Ophthalmology, Karadeniz Technical University Medical School, Trabzon, Turkey
| | - Erhan Çapkin
- Department of Orthopedics and Traumatology, Karadeniz Technical University Medical School, Trabzon, Turkey
| | - Ahmet Ayar
- Department of Physiology, Karadeniz Technical University Medical School, Trabzon, Turkey
| | - Adem Türk
- Department of Ophthalmology, Karadeniz Technical University Medical School, Trabzon, Turkey
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Kal A, Ulusoy MO, Öztürk C. Spectral domain optical coherence tomography findings of patients with ankylosing spondylitis. Int Ophthalmol 2020; 40:2727-2734. [PMID: 32533454 DOI: 10.1007/s10792-020-01458-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 05/29/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The aim of this study is to evaluate the possible effects of (ankylosing spondylitis) AS on choroidal thickness (CT) and other retinal layers using spectral domain optical coherence tomography (SD-OCT). METHODS This cross-sectional study group comprised 41 AS patients and age and sex-matched 46 control subjects. None of our patients had active anterior uveitis during the measurements. We evaluated and compared CT, retinal nerve fiber layer (RNFL) thickness, ganglion cell complex (GCC) thickness, focal loss volume (FLV) and global loss volume (GLV) of the participants. RESULTS The CT of the patients at 1500 µm (286.20 µm ± 65.81), 1000 µm (309.55 µm ± 85.33) nasally to the fovea and subfoveal layer (339.93 µm ± 69.93) were thicker than in controls (p = 0.007, p = 0.037, p = 0.008). Except nasal layer, all RNFL layers were significantly thinner than controls (p < 0.001). GCC and macular thickness were also thinner than controls (p < 0.001). CONCLUSION In conclusion, present findings may suggest that the AS disease may affect the choroidal, RNFL and GCC thickness by disease's own inflammatory effect, independently from the uveitis history.
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Affiliation(s)
- Ali Kal
- Department of Ophthalmology, School of Medicine, Konya Research Hospital, Başkent University, Konya, Turkey.
| | - Mahmut Oğuz Ulusoy
- Department of Ophthalmology, School of Medicine, Konya Research Hospital, Başkent University, Konya, Turkey
| | - Caner Öztürk
- Department of Ophthalmology, School of Medicine, Başkent University, Ankara, Turkey
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Akmaz B, Akay F, Işik MU, Güven YZ, Solmaz D, Gercik Ö, Kabadayı G, Kurut İ, Akar S. Retinal and choroidal vascular structures are affected in axial spondyloarthritis: an optical coherence tomography study. Int Ophthalmol 2020; 40:1977-1986. [PMID: 32328918 DOI: 10.1007/s10792-020-01372-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 04/10/2020] [Indexed: 01/17/2023]
Abstract
PURPOSE The aim of this study is to evaluate the retinal and choroidal structures in r- and nr-axSpA patients using spectral domain optical coherence tomography (SD-OCT) and to compare changes with healthy controls. METHODS In this cross-sectional study, 70 axSpA patients (50 radiographic- and 20 nr-axSpA) and 50 healthy control subjects were included. Choroidal thickness (ChT), macular thickness, retinal nerve fiber layer (RNFL), and the ganglion cell complex (GCC) were measured by SD-OCT. For ChT values, seven lines at nasal and temporal were drawn at 500-μm intervals, centering the subfoveal sclerochoroidal junction. Analysis of the data was performed with the SPSS program. Mann-Whitney U test was performed for comparison of non-normally distributed continuous data; Student's t test was used for normal distributed data. RESULTS No significant difference was observed between 70 (66% male; mean age 39.7 ± 10.4 years) axSpA patients (50 radiographic and 20 nr-axSpA) and 50 (mean age 41.2 ± 6.2 years) healthy control subjects (p 0.417). R-axSpA and nr-axSpA groups and control group were similar in terms of spherical equivalent, intraocular pressure, axial length, and body mass index (p 0.574, p 0.874, p 0.918, p 0.344, respectively). While mean macular and GCC thicknesses were significantly lower in the patient group than in the healthy group, there was no significant difference between the two groups in terms of RNFL thickness. CONCLUSION The present study showed that there was no significant relationship between markers and scores indicating disease activity and ChT, MT, RNFL, and GCC thicknesses. However, an increase in choroidal thickness and involvement of the retinal layers has also been demonstrated in patients with spondyloarthritis. In addition, the relationship between disease activity and retinal layer involvement is remarkable in the r-axSpA group.
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Affiliation(s)
- Berkay Akmaz
- Department of Ophthalmology, İzmir Katip Çelebi University Atatürk Educating and Research Hospital, 35200, İzmir, Turkey
| | - Fahrettin Akay
- Department of Ophthalmology, İzmir Katip Çelebi University Atatürk Educating and Research Hospital, 35200, İzmir, Turkey.
| | - Mehmet Uğur Işik
- Department of Ophthalmology, Balıklıgöl State Hospital, Şanlıurfa, Turkey
| | - Yusuf Ziya Güven
- Department of Ophthalmology, İzmir Katip Çelebi University Atatürk Educating and Research Hospital, 35200, İzmir, Turkey
| | - Dilek Solmaz
- Department of Rheumatology, İzmir Katip Çelebi University Atatürk Educating and Research Hospital, İzmir, Turkey
| | - Önay Gercik
- Department of Rheumatology, İzmir Katip Çelebi University Atatürk Educating and Research Hospital, İzmir, Turkey
| | - Gökhan Kabadayı
- Department of Rheumatology, İzmir Katip Çelebi University Atatürk Educating and Research Hospital, İzmir, Turkey
| | - İdil Kurut
- Department of Rheumatology, İzmir Katip Çelebi University Atatürk Educating and Research Hospital, İzmir, Turkey
| | - Servet Akar
- Department of Rheumatology, İzmir Katip Çelebi University Atatürk Educating and Research Hospital, İzmir, Turkey
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Steiner M, Esteban-Ortega MDM, Muñoz-Fernández S. Choroidal and retinal thickness in systemic autoimmune and inflammatory diseases: A review. Surv Ophthalmol 2019; 64:757-769. [PMID: 31034855 DOI: 10.1016/j.survophthal.2019.04.007] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 04/14/2019] [Accepted: 04/22/2019] [Indexed: 12/22/2022]
Abstract
To identify the risk of relapse and subclinical inflammatory stages of systemic autoimmune diseases, new tools are needed. In the recent years, choroidal thickness and retinal thickness measured with ocular coherence tomography (OCT) have been proposed as an inflammatory marker for different systemic diseases, especially for conditions with a vascular component. Our aim in this article is to review the literature regarding the role of choroidal and retinal thickness as a potential inflammatory marker in systemic autoimmune and inflammatory diseases measured by OCT. Current literature suggests that the choroid of patients thickens in active phases of inflammatory diseases with vascular involvement. This pattern is observed in lupus, systemic sclerosis, Behçet disease, spondylitis, and familial Mediterranean fever. Choroidal thickness may decrease with biological treatments, along with systemic inflammation. Repeated flares and long-term disease, however, may thin the choroid, as a result of prolonged insult to the microvasculature and subsequent atrophy. Less is known about the effect of these diseases on retinal thickness. In summary, choroidal and retinal thickness measured by OCT may be promising markers for inflammation in systemic autoimmune and inflammatory diseases; however, more studies are warranted before generalizing choroidal thickness measurements by OCT as a marker for disease activity. The role of retinal thickness is more unclear due to a lack of studies in this field.
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Affiliation(s)
- Martina Steiner
- Department of Rheumatology, Infanta Sofía University Hospital, San Sebastián de los Reyes, Madrid, Spain; Universidad Europea de Madrid, Madrid, Spain.
| | - Maria Del Mar Esteban-Ortega
- Universidad Europea de Madrid, Madrid, Spain; Department of Ophthalmology, Infanta Sofía University Hospital, San Sebastián de los Reyes, Madrid, Spain
| | - Santiago Muñoz-Fernández
- Department of Rheumatology, Infanta Sofía University Hospital, San Sebastián de los Reyes, Madrid, Spain; Universidad Europea de Madrid, Madrid, Spain
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Peripapillary retinal nerve fiber layer and ganglion cell–inner plexiform layer thickness in adult-onset familial Mediterranean fever. Int Ophthalmol 2017; 38:183-190. [DOI: 10.1007/s10792-017-0446-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Accepted: 01/05/2017] [Indexed: 10/20/2022]
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Biomechanical evaluation of cornea in patients with ankylosing spondylitis. Int Ophthalmol 2016; 37:1017-1024. [DOI: 10.1007/s10792-016-0368-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 09/30/2016] [Indexed: 10/20/2022]
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Alim S, Özer S, Demir S, Ortak H, Sönmezgöz E, Er E, Demir O. Peripapillary Retinal Nerve Fiber Layer and Ganglion Cell–Inner Plexiform Layer Thickness in Children with Familial Mediterranean Fever. Ocul Immunol Inflamm 2016; 24:372-6. [DOI: 10.3109/09273948.2015.1100747] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Sait Alim
- Department of Ophthalmology, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey
| | - Samet Özer
- Department of Pediatrics, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey
| | - Selim Demir
- Department of Ophthalmology, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey
| | - Hüseyin Ortak
- Department of Ophthalmology, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey
| | - Ergün Sönmezgöz
- Department of Pediatrics, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey
| | - Ergün Er
- Department of Ophthalmology, Niksar State Hospital, Tokat, Turkey
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Tas A, Yolcu U, Ilhan A, Gundogan FC. Peripapillary Retinal Nerve Fiber Layer and Ganglion Cell-Inner Plexiform Layers Thickness in Ankylosing Spondylitis. Ocul Immunol Inflamm 2015; 23:468. [PMID: 26110632 DOI: 10.3109/09273948.2014.1003660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Ahmet Tas
- a Agri Military Hospital, Ophthalmology Service , Agrı , Turkey
| | - Umit Yolcu
- b Sarıkamış Military Hospital, Ophthalmology Service , Kars , Turkey
| | - Abdullah Ilhan
- c Erzurum Military Hospital, Ophthalmology Service , Erzurum , Turkey , and
| | - Fatih C Gundogan
- d GATA Medical School, Department of Ophthalmology , Ankara , Turkey
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Cunningham ET, van Velthoven MEJ, Zierhut M. Spectral-Domain-Optical Coherence Tomography in Uveitis. Ocul Immunol Inflamm 2014; 22:425-8. [DOI: 10.3109/09273948.2014.982060] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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