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通过脉络膜血管指数评估幼年特发性关节炎的全身和眼部炎症。

Assessment of systemic and ocular inflammation in juvenile idiopathic arthritis via choroidal vascularity index.

机构信息

Department of Ophthalmology, University of Health Sciences, Haseki Training and Research Hospital, Fatih, 34130, Istanbul, Turkey.

Department of Ophthalmology, Hacettepe University School of Medicine, Sihhiye, 06100, Ankara, Turkey.

出版信息

Rheumatol Int. 2022 Jul;42(7):1187-1196. doi: 10.1007/s00296-021-05023-x. Epub 2021 Oct 11.

Abstract

We aimed to evaluate the retina and the choroid in children with juvenile idiopathic arthritis (JIA) employing optical coherence tomography (OCT). This cross-sectional study, carried out between June 2017-December 2019, included JIA patients with (JIAU; n = 28) and without (JIAN; n = 65) uveitis and age-matched healthy controls (HC) (n = 102). Laboratory and demographic information of the children were obtained from hospital records. Activity of the disease was evaluated by the Juvenile Arthritis Disease Activity Score-71 (JADAS-71). Choroidal scans were obtained with spectral domain-OCT in enhanced-depth imaging (EDI)-OCT mode to assess choroidal thickness (ChT) at five locations (under the fovea, at 750 and 1500 μm nasal and temporal sections), luminal area (LA), stromal area (SA), total subfoveal choroidal area (TCA) and CVI (choroidal vascularity index). Central foveal thickness (CFT) and 1-mm diameter foveal thickness (FT) were calculated automatically through macular volume scan analysis. The choroid was significantly thicker in JIAU and JIAN patients than in HC at the subfoveal and at the 750N, 750T, 1500T points (p < 0.001, p = 0.009, p < 0.001, and p < 0.001, respectively). The CVI was lower in JIAU patients than in JIAN patients and HC (p = 0.02). Conversely, CFT was greater in JIAU patients as compared to the JIAN patients and HC (p = 0.02). Changes in chorioretinal OCT parameters in the absence of uveitis in JIA patients may reflect subclinical choroidal inflammation in these patients. Ophthalmologic examination, including choroidal imaging in a larger cohort, may clarify this aspect.

摘要

我们旨在通过光学相干断层扫描(OCT)评估幼年特发性关节炎(JIA)儿童的视网膜和脉络膜。这项横断面研究于 2017 年 6 月至 2019 年 12 月进行,纳入了伴(JIAU;n=28)和不伴(JIAN;n=65)葡萄膜炎的 JIA 患者以及年龄匹配的健康对照组(HC)(n=102)。从医院记录中获取了儿童的实验室和人口统计学信息。疾病活动通过幼年关节炎疾病活动评分-71(JADAS-71)进行评估。采用光谱域 OCT 在增强深度成像(EDI)-OCT 模式下进行脉络膜扫描,以评估五个位置(黄斑下、鼻侧和颞侧 750 和 1500μm 处)的脉络膜厚度(ChT)、管腔面积(LA)、基质面积(SA)、总下脉络膜面积(TCA)和 CVI(脉络膜血管指数)。通过黄斑容积扫描分析自动计算中心凹视网膜厚度(CFT)和 1mm 直径中心凹视网膜厚度(FT)。JIAU 和 JIAN 患者的脉络膜在黄斑下和 750N、750T、1500T 处均明显比 HC 厚(p<0.001,p=0.009,p<0.001 和 p<0.001)。JIAU 患者的 CVI 低于 JIAN 患者和 HC(p=0.02)。相反,JIAU 患者的 CFT 大于 JIAN 患者和 HC(p=0.02)。JIA 患者在无葡萄膜炎的情况下,脉络膜视网膜 OCT 参数的变化可能反映了这些患者的亚临床脉络膜炎症。眼科检查,包括在更大的队列中进行脉络膜成像,可能会阐明这一方面。

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