Abstract
Purpose
To investigate the choroidal thickness in patients with scleroderma and to compare them with healthy control subjects.
Methods
Forty-six patients with scleroderma (3 male and 43 female) and 31 healthy controls (6 male and 25 female) were included in the study. Twenty-five patients had limited-type and 21 patients had diffuse-type scleroderma. Only left eyes of the patients and control subjects were used in the analysis. Demographic features of all the patients and control subjects were recorded. Each subject underwent ophthalmological examinations including refraction, visual acuity, intraocular pressure, axial length (AXL) measurement, slit-lamp biomicroscopy, and fundus examination. Body mass index (BMI) was estimated for all participants.
Results
There were no significant differences between the patients with scleroderma and the control subjects in terms of age, gender, BMI, mean AXL, and mean spherical equivalent refractive error (SE) (P=0.1, P=0.086, P=0.37, P=0.55, and P=0.072 respectively). The patients with scleroderma had significantly thinner nasal, temporal, and subfoveal choroid than the healthy control subjects (P1=0.012, P2=0.046, and P3<0.001, respectively). There were no significant differences between the patients with limited-type and diffuse-type scleroderma in terms of age, gender, BMI, mean AXL, mean SE, nasal, temporal, and subfoveal choroidal thicknesses (all P>0.05).
Conclusions
Choroidal thickness in patients with scleroderma was significantly less than healthy control subjects. Vasculopathy in scleroderma is characterized by obliteration of arterioles and reduced capillary density may cause atrophy of choroid in patients with scleroderma.
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References
Sakkas LI . New developments in the pathogenesis of systemic sclerosis. Autoimmunity 2005; 38 (2): 113–116.
Rabquer BJ, Koch AE . Angiogenesis and vasculopathy in systemic sclerosis: evolving concepts. Curr Rheumatol Rep 2012; 14 (1): 56–63.
Gomes Bde A, Santhiago MR, Magalhaes P, Kara-Junior N, Azevedo MN, Moraes HV Jr . Ocular findings in patients with systemic sclerosis. Clinics 2011; 66 (3): 379–385.
Tailor R, Gupta A, Herrick A, Kwartz J . Ocular manifestations of scleroderma. Surv Ophthalmol 2009; 54 (2): 292–304.
Hesse RJ, Slagle DF 2nd . Scleroderma choroidopathy: report of an unusual case. Ann Ophthalmol 1982; 14 (6): 524–525.
Farkas TG, Sylvester V, Archer D . The choroidopathy of progressive systemic sclerosis (scleroderma). Am J Ophthalmol 1972; 74 (5): 875–886.
Wangsa-Wirawan ND, Linsenmeier RA . Retinal oxygen: fundamental and clinical aspects. Arch Ophthalmol 2003; 121 (4): 547–557.
Coskun E, Okumus S, Gurler B, Yayuspayi R, Oren B, Kaydu E et al. Choroidal thickness in healthy Turkish subjects. Turk J Med Sci 2014; 44 (1): 56–61.
Gupta P, Saw SM, Cheung CY, Girard MJ, Mari JM, Bhargava M et al. Choroidal thickness and high myopia: a case-control study of young Chinese men in Singapore. Acta Ophthalmol 2014; 93 (7): e585–e592.
Rishi P, Rishi E, Mathur G, Raval V . Ocular perfusion pressure and choroidal thickness in eyes with polypoidal choroidal vasculopathy, wet-age-related macular degeneration, and normals. Eye 2013; 27 (9): 1038–1043.
Kang NH, Kim YT . Change in subfoveal choroidal thickness in central serous chorioretinopathy following spontaneous resolution and low-fluence photodynamic therapy. Eye 2013; 27 (3): 387–391.
Li Z, Wang W, Zhou M, Huang W, Chen S, Li X et al. Enhanced depth imaging-optical coherence tomography of the choroid in moderate and severe primary angle-closure glaucoma. Acta Ophthalmol 2015; 93 (5): e349–e355.
Eroglu FC, Asena L, Simsek C, Kal A, Yilmaz G . Evaluation of choroidal thickness using enhanced depth imaging by spectral-domain optical coherence tomography in patients with pseudoexfoliation syndrome. Eye 2015; 29 (6): 791–796.
Mehta H, Sim DA, Keane PA, Zarranz-Ventura J, Gallagher K, Egan CA et al. Structural changes of the choroid in sarcoid- and tuberculosis-related granulomatous uveitis. Eye 2015; 29 (8): 1060–1068.
Coskun E, Gurler B, Pehlivan Y, Kisacik B, Okumus S, Yayuspayi R et al. Enhanced depth imaging optical coherence tomography findings in Behcet disease. Ocul Immunol Inflamm 2013; 21 (6): 440–445.
Preliminary criteria for the classification of systemic sclerosis (scleroderma). Subcommittee for scleroderma criteria of the American Rheumatism Association Diagnostic and Therapeutic Criteria Committee. Arthritis Rheum 1980; 23 (5): 581–590.
Milenkovic S, Petrovic L, Risimic D, Kosanovic-Jakovic N, Jaksic V, Djakovic Z et al. Choroidal sclerosis in localized scleroderma (morphea en plaque). Ophthalmic Res 2008; 40 (2): 101–104.
Abdellatief A, Balasubramaniam SC, Grube TJ, Gonzalez Santiago TM, Osborn TG, Pulido JS . Indocyanine green angiographic evidence of choroiditis in scleroderma. Retin Cases Brief Rep 2015; 9 (3): 231–234.
Ingegnoli F, Gualtierotti R, Pierro L, Del Turco C, Miserocchi E, Schioppo T et al. Choroidal impairment and macular thinning in patients with systemic sclerosis: the acute study. Microvasc Res 2015; 97: 31–36.
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 (2): 152–156.
Maclean H, Guthrie W . Retinopathy in scleroderma. Trans Ophthalmol Soc UK 1970; 89: 209–220.
Polak K, Luksch A, Berisha F, Fuchsjaeger-Mayrl G, Dallinger S, Schmetterer L . Altered nitric oxide system in patients with open-angle glaucoma. Arch Ophthalmol 2007; 125 (4): 494–498.
Delgado E, Marques-Neves C, Rocha I, Sales-Luis J, Silva-Carvalho L . Intrinsic vasomotricity and adrenergic effects in a model of isolated rabbit eye. Acta Ophthalmol 2009; 87 (4): 443–449.
Usui S, Ikuno Y, Akiba M, Maruko I, Sekiryu T, Nishida K et al. Circadian changes in subfoveal choroidal thickness and the relationship with circulatory factors in healthy subjects. Invest Ophthalmol Vis Sci 2012; 53 (4): 2300–2307.
Serup L, Serup J, Hagdrup H . Fundus fluorescein angiography in generalized scleroderma. Ophthalmic Res 1987; 19 (5): 303–308.
Kraus A, Guerra-Bautista G, Espinoza G, Barojas E, Quiroz-Mercado H, Sanchez-Echeverri G et al. Defects of the retinal pigment epithelium in scleroderma. Br J Rheumatol 1991; 30 (2): 112–114.
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We acknowledge the kind assistant of associate professor Veysi Öner in reviewing the article.
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Coşkun, E., Zengin, O., Kenan, S. et al. Evaluation of choroidal thickness in patients with scleroderma. Eye 30, 588–592 (2016). https://doi.org/10.1038/eye.2015.287
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DOI: https://doi.org/10.1038/eye.2015.287
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