Author: Gulfidan Bitirgen
Co-authors: Adem Kucuk, Mustafa Cagri Ergun
Abstract
Purpose: This study aims to evaluate the changes in central macular thickness (CMT), total macular volume (TMV), and the thicknesses of macular inner retinal layers using spectral domain optical coherence tomography (SD-OCT) in patients with rheumatoid arthritis (RA).Setting/Venue: The study was undertaken at the Department of Ophthalmology, Necmettin Erbakan University Meram Medical Faculty Hospital, Konya, Turkey.
Methods: Thirty-six patients with RA and 25 healthy subjects were enrolled in this cross-sectional study. Patients with coexisting retinal or neurological pathologies were excluded. The severity of disease activity was determined using the 28-Joint Disease Activity Score and erythrocyte sedimentation rate (DAS28-ESR). After a complete ophthalmologic evaluation, all participants underwent SD-OCT (Heidelberg, Germany) imaging with automated retinal layer segmentation. In addition to CMT and TMV, the average thicknesses of nerve fiber layer (NFL), ganglion cell layer (GCL), inner plexiform layer (IPL) and inner nuclear layer (INL) at the central fovea (1 mm) and four quadrants (superior, inferior, nasal, temporal) of the parafoveal region (1-3 mm) were recorded. For all participants, only the data obtained from the right eye were included in statistical analyses.
Results: The mean age of patients with RA and control subjects were 49.6 ± 9.2 years and 46.2 ± 11.2 years, respectively (P = 0.211). The median time from the initial diagnosis of RA was 8.0 years. Patients with RA showed significant reductions in NFL thickness at central (P = 0.020), superior (P = 0.002), inferior (P = 0.016), nasal (P = 0.003) and temporal (P = 0.006) regions, GCL thickness at central (P = 0.002) and temporal (P = 0.031) regions, and IPL thickness at the central foveal zone (P = 0.022), with no differences in CMT and TMV compared to control participants. DAS28-ESR inversely correlated with NFL-central (rho = -0.369; P = 0.027), GCL-central (rho = -0.335; P = 0.046), IPL-central (rho = -0.333; P = 0.047), and CMT (rho = -0.333; P = 0.047).
Conclusions: This study demonstrated significant reductions in central inner retinal layer thicknesses in patients with RA. Furthermore, the severity of disease activity was related with the thinning of inner retina. These findings need to be confirmed by prospective studies to determine whether retinal neurodegeneration progresses during the course of RA.
Financial Disclosure: The authors have no financial relationship to disclose.
