Retinal changes in children with Familial Mediterranean Fever: the effect of chronic subclinical inflammation.

BACKGROUND

In Familial Mediterranean Fever (FMF), acute-phase reactants rise during attacks, indicating active inflammation. However, subclinical inflammation-present even during remission-may contribute to organ damage, including ocular involvement. This study aimed to investigate the effects of subclinical chronic inflammation on ocular structures in children with FMF.

METHODS

The study involved 51 pediatric FMF patients in remission for at least three months and healthy controls. Spectral domain optical coherence tomography (SD-OCT) was used to measure intraocular pressure, axial length, peripapillary retinal nerve fiber layer (RNFL) thickness, central macular thickness, and subfoveal choroidal thickness.

RESULTS

Acute-phase reactant levels were significantly elevated in the FMF group (p < 0.001). Inferotemporal RNFL thickness was notably reduced (p = 0.008), along with central macular, subfoveal, nasal, and temporal choroidal thicknesses. A mild positive correlation was observed between proteinuria and axial length (r = 0.282, p = 0.045).

CONCLUSION

Subclinical inflammation in FMF may lead to early structural changes in the eye, potentially progressing over time. These findings highlight the importance of long-term ophthalmologic monitoring in pediatric FMF patients to better understand the cumulative impact of persistent inflammation.

IMPACT

This study assessed peripapillary RNFL thickness and choroidal vascular structure in children with FMF using SD-OCT to evaluate ocular effects of subclinical inflammation. It was found that chronic inflammation may lead to thinning of the retina and choroid even in children with relatively short disease duration. Peripapillary RNFL thickness was reduced in the temporal inferior quadrant and correlated with serum amyloid levels; additionally, choroidal thickness was significantly lower in the patient group, suggesting early ocular involvement and its potential as a marker of subclinical systemic inflammation.