Moleiro Ana Filipa, Aires Ana Francisca, Alves Hélio, Viana Pinto João, Carneiro Ângela, Falcão-Reis Fernando, Figueira Luís, Pinheiro-Costa João
Department of Ophthalmology, Centro Hospitalar Universitário São João, Porto, Portugal.
Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal.
Clin Ophthalmol. 2021 Apr 28;15:1799-1807. doi: 10.2147/OPTH.S301330. eCollection 2021.
Although classically classified as a non-inflammatory condition, an inflammatory basis for keratoconus (KC) appears to be a growing evidence. Recently, it has been shown that KC patients have an increased choroidal thickness (CT). Among inflammatory disorders, atopy has been associated with KC development; therefore, the aim of this study was to evaluate if the increased CT in patients with KC is related to atopy.
This is an analytical cross-sectional study of patients with KC. Patients were classified as atopic and non-atopic according to their atopy history (allergic rhinoconjunctivitis (AR), asthma (AA) and/or atopic dermatitis (AD)) and were also classified based on their eye rubbing habits. Choroidal profile of all subjects was evaluated using a Spectralis optical coherence tomography (OCT) device with enhanced depth imaging (EDI) mode. CT was measured and compared between groups at the center of the fovea and at 500 µm intervals along a horizontal section. A multivariable analysis, adjusted for sex, age, spherical equivalent, history of medication and atopy, was performed to assess the influence of atopy in CT.
Of the 80 patients included, 51 were atopic and 29 non-atopic. Atopic patients showed a thicker choroid in every measured location than the non-atopic patients (mean subfoveal CT 391.53 µm vs 351.17 µm, respectively), although the differences were not statistically different. The multivariable analysis revealed that being atopic makes the choroid statistically thicker, on average, 55.14 µm, when compared to non-atopic patients (p=0.043). Furthermore, patients who are frequent eye rubbers have significantly thicker choroids than non-rubbers (p=0.004).
Although some results do not reach statistical significance, atopic KC patients seem to have thicker choroids compared with non-atopic KC patients, suggesting a possible role for atopy in the choroidal profile of KC. This constitutes a completely new sight in this field of research that needs further investigation.
尽管圆锥角膜（KC）传统上被归类为非炎症性疾病，但越来越多的证据表明其存在炎症基础。最近研究显示，KC患者脉络膜厚度（CT）增加。在炎症性疾病中，特应性与KC的发生有关；因此，本研究的目的是评估KC患者CT增加是否与特应性有关。
这是一项对KC患者的分析性横断面研究。根据患者的特应性病史（过敏性鼻结膜炎（AR）、哮喘（AA）和/或特应性皮炎（AD））将其分为特应性和非特应性，同时根据揉眼习惯进行分类。使用具有增强深度成像（EDI）模式的Spectralis光学相干断层扫描（OCT）设备评估所有受试者的脉络膜形态。在黄斑中心以及沿水平截面每隔500 µm测量并比较两组之间的CT。进行多变量分析，对性别、年龄、等效球镜、用药史和特应性进行校正，以评估特应性对CT的影响。
纳入的80例患者中，51例为特应性，29例为非特应性。在每个测量位置，特应性患者的脉络膜均比非特应性患者厚（黄斑下平均CT分别为391.53 µm和351.17 µm），尽管差异无统计学意义。多变量分析显示，与非特应性患者相比，特应性使脉络膜平均在统计学上厚55.14 µm（p = 0.043）。此外，频繁揉眼的患者脉络膜比不揉眼的患者明显更厚（p = 0.004）。
尽管一些结果未达到统计学意义，但与非特应性KC患者相比，特应性KC患者的脉络膜似乎更厚，这表明特应性在KC脉络膜形态中可能起作用。这为该研究领域提供了一个全新的视角，需要进一步研究。
