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Published in: International Ophthalmology 8/2020

01-08-2020 | Uveitis | Original Paper

Retinal and choroidal vascular structures are affected in axial spondyloarthritis: an optical coherence tomography study

Authors: Berkay Akmaz, Fahrettin Akay, Mehmet Uğur Işik, Yusuf Ziya Güven, Dilek Solmaz, Önay Gercik, Gökhan Kabadayı, İdil Kurut, Servet Akar

Published in: International Ophthalmology | Issue 8/2020

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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.
Literature
1.
go back to reference van der Linden S, Valkenburg HA, Cats A (1984) Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum. 27(4):361–368CrossRef van der Linden S, Valkenburg HA, Cats A (1984) Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum. 27(4):361–368CrossRef
2.
go back to reference Sieper J, van der Heijde D (2013) Review: Nonradiographic axial spondyloarthritis: new definition of an old disease? Arthritis Rheum 65(3):543–551PubMedCrossRef Sieper J, van der Heijde D (2013) Review: Nonradiographic axial spondyloarthritis: new definition of an old disease? Arthritis Rheum 65(3):543–551PubMedCrossRef
4.
go back to reference Stolwijk C, van Tubergen A, Castillo-Ortiz JD, Boonen A (2015) Prevalence of extra-articular manifestations in patients with ankylosing spondylitis: a systematic review and meta-analysis. Ann Rheum Dis 74(1):65–73PubMedCrossRef Stolwijk C, van Tubergen A, Castillo-Ortiz JD, Boonen A (2015) Prevalence of extra-articular manifestations in patients with ankylosing spondylitis: a systematic review and meta-analysis. Ann Rheum Dis 74(1):65–73PubMedCrossRef
5.
go back to reference Rosenbaum JT (1989) Characterization of uveitis associated with spondyloarthritis. J Rheumatol 16(6):792–796PubMed Rosenbaum JT (1989) Characterization of uveitis associated with spondyloarthritis. J Rheumatol 16(6):792–796PubMed
6.
go back to reference Unterhuber A, Povazay B, Hermann B, Sattmann H, Chavez-Pirson A, Drexler W (2005) In vivo retinal optical coherence tomography at 1040 nm - enhanced penetration into the choroid. Opt Express 13(9):3252–3258PubMedCrossRef Unterhuber A, Povazay B, Hermann B, Sattmann H, Chavez-Pirson A, Drexler W (2005) In vivo retinal optical coherence tomography at 1040 nm - enhanced penetration into the choroid. Opt Express 13(9):3252–3258PubMedCrossRef
7.
go back to reference Isik MU, Yalcindag N (2018) Comparison of spectral domain optical coherence tomography (SD OCT) findings with laser flare photometry (LFP) measurements in Behcet's Uveitis. Ocul Immunol Inflamm. 2018:1–6 Isik MU, Yalcindag N (2018) Comparison of spectral domain optical coherence tomography (SD OCT) findings with laser flare photometry (LFP) measurements in Behcet's Uveitis. Ocul Immunol Inflamm. 2018:1–6
8.
go back to reference Tetikoglu M, Temizturk F, Sagdik HM, Aktas S, Ozcura F, Ozkan Y, Temiztürk S (2017) Evaluation of the choroid, fovea, and retinal nerve fiber layer in patients with rheumatoid arthritis. Ocul Immunol Inflamm 25(2):210–214PubMedCrossRef Tetikoglu M, Temizturk F, Sagdik HM, Aktas S, Ozcura F, Ozkan Y, Temiztürk S (2017) Evaluation of the choroid, fovea, and retinal nerve fiber layer in patients with rheumatoid arthritis. Ocul Immunol Inflamm 25(2):210–214PubMedCrossRef
9.
go back to reference Traill A, Stawell R, Hall A, Zamir E (2007) Macular thickening in acute anterior uveitis. Ophthalmology 114(2):402PubMedCrossRef Traill A, Stawell R, Hall A, Zamir E (2007) Macular thickening in acute anterior uveitis. Ophthalmology 114(2):402PubMedCrossRef
10.
go back to reference Szepessy Z, Barsi A, Nemeth J (2016) Macular changes correlate with the degree of acute anterior uveitis in patients with spondyloarthropathy. Ocul Immunol Inflamm 24(2):153–158PubMed Szepessy Z, Barsi A, Nemeth J (2016) Macular changes correlate with the degree of acute anterior uveitis in patients with spondyloarthropathy. Ocul Immunol Inflamm 24(2):153–158PubMed
11.
go back to reference Jabs D, Nussenblatt R, Rosenbaum J (2005) The Standardization of Uveitis Nomenclature (SUN) Working Group. Standardization of uveitis nomenclature for reporting clinical data. Results of the First International Workshop. Am J Ophthalmol. 140:509–516PubMedCrossRef Jabs D, Nussenblatt R, Rosenbaum J (2005) The Standardization of Uveitis Nomenclature (SUN) Working Group. Standardization of uveitis nomenclature for reporting clinical data. Results of the First International Workshop. Am J Ophthalmol. 140:509–516PubMedCrossRef
12.
go back to reference Rudwaleit M, van der Heijde D, Landewe R, Listing J, Akkoc N, Brandt J, Braun J, Chou C, T, Collantes-Estevez E, Dougados M, et al (2009) The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis. 68(6):777–783PubMedCrossRef Rudwaleit M, van der Heijde D, Landewe R, Listing J, Akkoc N, Brandt J, Braun J, Chou C, T, Collantes-Estevez E, Dougados M, et al (2009) The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis. 68(6):777–783PubMedCrossRef
13.
go back to reference Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A (1994) A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index. J Rheumatol 21(12):2286–2291PubMed Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A (1994) A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index. J Rheumatol 21(12):2286–2291PubMed
14.
go back to reference Calin A, Garrett S, Whitelock H, Kennedy LG, O'Hea J, Mallorie P, Jenkinson T (1994) A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath Ankylosing Spondylitis Functional Index. J Rheumatol 21(12):2281–2285PubMed Calin A, Garrett S, Whitelock H, Kennedy LG, O'Hea J, Mallorie P, Jenkinson T (1994) A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath Ankylosing Spondylitis Functional Index. J Rheumatol 21(12):2281–2285PubMed
15.
go back to reference Machado P, Landewe R, Lie E, Kvien TK, Braun J, Baker D, van der Heijde D (2011) Ankylosing Spondylitis Disease Activity Score (ASDAS): defining cut-off values for disease activity states and improvement scores. Ann Rheum Dis 70(1):47–53PubMedCrossRef Machado P, Landewe R, Lie E, Kvien TK, Braun J, Baker D, van der Heijde D (2011) Ankylosing Spondylitis Disease Activity Score (ASDAS): defining cut-off values for disease activity states and improvement scores. Ann Rheum Dis 70(1):47–53PubMedCrossRef
16.
go back to reference Sharma SM, Jackson D (2017) Uveitis and spondyloarthropathies. Best Pract Res Clin Rheumatol 31(6):846–862PubMedCrossRef Sharma SM, Jackson D (2017) Uveitis and spondyloarthropathies. Best Pract Res Clin Rheumatol 31(6):846–862PubMedCrossRef
17.
go back to reference Tan KA, Gupta P, Agarwal A, Chhablani J, Cheng CY, Keane PA, Agrawal R (2016) State of science: Choroidal thickness and systemic health. Surv Ophthalmol 61(5):566–581PubMedCrossRef Tan KA, Gupta P, Agarwal A, Chhablani J, Cheng CY, Keane PA, Agrawal R (2016) State of science: Choroidal thickness and systemic health. Surv Ophthalmol 61(5):566–581PubMedCrossRef
18.
go back to reference Adhi M, Lau M, Liang MC, Waheed NK, Duker JS (2014) Analysis of the thickness and vascular layers of the choroid in eyes with geographic atrophy using spectral-domain optical coherence tomography. Retina 34(2):306–312PubMedCrossRef Adhi M, Lau M, Liang MC, Waheed NK, Duker JS (2014) Analysis of the thickness and vascular layers of the choroid in eyes with geographic atrophy using spectral-domain optical coherence tomography. Retina 34(2):306–312PubMedCrossRef
19.
go back to reference Terasaki H, Kase S, Shirasawa M, Otsuka H, Hisatomi T, Sonoda S, Ishida S, Ishibashi T, Sakamoto T (2013) TNF-alpha decreases VEGF secretion in highly polarized RPE cells but increases it in non-polarized RPE cells related to crosstalk between JNK and NF-kappaB pathways. PLoS ONE 8(7):e69994PubMedPubMedCentralCrossRef Terasaki H, Kase S, Shirasawa M, Otsuka H, Hisatomi T, Sonoda S, Ishida S, Ishibashi T, Sakamoto T (2013) TNF-alpha decreases VEGF secretion in highly polarized RPE cells but increases it in non-polarized RPE cells related to crosstalk between JNK and NF-kappaB pathways. PLoS ONE 8(7):e69994PubMedPubMedCentralCrossRef
20.
go back to reference Kola M, Kalkisim A, Karkucak M, Turk A, Capkin E, Can I, Serdar OF, Mollamehmehmetoğlu S, Ayar A (2014) Evaluation of choroidal thickness in ankylosing spondylitis using optical coherence tomography. Ocul Immunol Inflamm 22(6):434–438PubMedCrossRef Kola M, Kalkisim A, Karkucak M, Turk A, Capkin E, Can I, Serdar OF, Mollamehmehmetoğlu S, Ayar A (2014) Evaluation of choroidal thickness in ankylosing spondylitis using optical coherence tomography. Ocul Immunol Inflamm 22(6):434–438PubMedCrossRef
21.
go back to reference Basarir B, Celik U, Altan C, Celik NB (2018) Choroidal thickness changes determined by EDI-OCT on acute anterior uveitis in patients with HLA-B27-positive ankylosing spondylitis. Int Ophthalmol 38(1):307–312PubMed Basarir B, Celik U, Altan C, Celik NB (2018) Choroidal thickness changes determined by EDI-OCT on acute anterior uveitis in patients with HLA-B27-positive ankylosing spondylitis. Int Ophthalmol 38(1):307–312PubMed
22.
go back to reference Poddubnyy D, Sieper J (2014) Similarities and differences between nonradiographic and radiographic axial spondyloarthritis: a clinical, epidemiological and therapeutic assessment. Curr Opin Rheumatol 26(4):377–383PubMedCrossRef Poddubnyy D, Sieper J (2014) Similarities and differences between nonradiographic and radiographic axial spondyloarthritis: a clinical, epidemiological and therapeutic assessment. Curr Opin Rheumatol 26(4):377–383PubMedCrossRef
23.
go back to reference Ayhan Tuzcu E, Ustun N, Ilhan N, Yagiz E, Daglioglu MC, Coskun M, Ilhan O, Keskin U, Yengil E (2014) Peripapillary retinal nerve fiber layer and ganglion cell-inner plexiform layers thickness in ankylosing spondylitis. Ocul Immunol Inflamm 22(6):429–433PubMedCrossRef Ayhan Tuzcu E, Ustun N, Ilhan N, Yagiz E, Daglioglu MC, Coskun M, Ilhan O, Keskin U, Yengil E (2014) Peripapillary retinal nerve fiber layer and ganglion cell-inner plexiform layers thickness in ankylosing spondylitis. Ocul Immunol Inflamm 22(6):429–433PubMedCrossRef
24.
go back to reference Shulman S, Goldenberg D, Habot-Wilner Z, Goldstein M, Neudorfer M (2012) Optical coherence tomography characteristics of eyes with acute anterior uveitis. Isr Med Assoc J 14(9):543–546PubMed Shulman S, Goldenberg D, Habot-Wilner Z, Goldstein M, Neudorfer M (2012) Optical coherence tomography characteristics of eyes with acute anterior uveitis. Isr Med Assoc J 14(9):543–546PubMed
26.
go back to reference Desai D, He S, Yorio T, Krishnamoorthy RR, Prasanna G (2004) Hypoxia augments TNF-alpha-mediated endothelin-1 release and cell proliferation in human optic nerve head astrocytes. Biochem Biophys Res Commun 318(3):642–648PubMedCrossRef Desai D, He S, Yorio T, Krishnamoorthy RR, Prasanna G (2004) Hypoxia augments TNF-alpha-mediated endothelin-1 release and cell proliferation in human optic nerve head astrocytes. Biochem Biophys Res Commun 318(3):642–648PubMedCrossRef
27.
go back to reference Al-Gayyar MM, Abdelsaid MA, Matragoon S, Pillai BA, El-Remessy AB (2011) Thioredoxin interacting protein is a novel mediator of retinal inflammation and neurotoxicity. Br J Pharmacol 164(1):170–180PubMedPubMedCentralCrossRef Al-Gayyar MM, Abdelsaid MA, Matragoon S, Pillai BA, El-Remessy AB (2011) Thioredoxin interacting protein is a novel mediator of retinal inflammation and neurotoxicity. Br J Pharmacol 164(1):170–180PubMedPubMedCentralCrossRef
28.
go back to reference Kitaoka Y, Kitaoka Y, Kwong JM, Ross-Cisneros FN, Wang J, Tsai RK, Sadun AA, Lam TT (2006) TNF-alpha-induced optic nerve degeneration and nuclear factor-kappaB p65. Invest Ophthalmol Vis Sci 47(4):1448–1457PubMedCrossRef Kitaoka Y, Kitaoka Y, Kwong JM, Ross-Cisneros FN, Wang J, Tsai RK, Sadun AA, Lam TT (2006) TNF-alpha-induced optic nerve degeneration and nuclear factor-kappaB p65. Invest Ophthalmol Vis Sci 47(4):1448–1457PubMedCrossRef
Metadata
Title
Retinal and choroidal vascular structures are affected in axial spondyloarthritis: an optical coherence tomography study
Authors
Berkay Akmaz
Fahrettin Akay
Mehmet Uğur Işik
Yusuf Ziya Güven
Dilek Solmaz
Önay Gercik
Gökhan Kabadayı
İdil Kurut
Servet Akar
Publication date
01-08-2020
Publisher
Springer Netherlands
Published in
International Ophthalmology / Issue 8/2020
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI
https://doi.org/10.1007/s10792-020-01372-x

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