Sav Nadide M, Teberik Kuddusi
Department of Pediatric Nephrology, Duzce University, Duzce, Turkey.
Department of Ophthalmology, Duzce University, Duzce, Turkey.
Pediatr Res. 2025 Jun 6. doi: 10.1038/s41390-025-04195-7.
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.
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.
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).
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.
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.
在家族性地中海热（FMF）中，急性期反应物在发作期间会升高，表明存在活动性炎症。然而，即使在缓解期也存在的亚临床炎症可能会导致器官损伤，包括眼部受累。本研究旨在调查亚临床慢性炎症对FMF患儿眼部结构的影响。
该研究纳入了51例处于缓解期至少三个月的儿科FMF患者和健康对照。使用光谱域光学相干断层扫描（SD-OCT）测量眼压、眼轴长度、视乳头周围视网膜神经纤维层（RNFL）厚度、中心黄斑厚度和黄斑下脉络膜厚度。
FMF组急性期反应物水平显著升高（p < 0.001）。颞下象限RNFL厚度显著降低（p = 0.008），同时中心黄斑、黄斑下、鼻侧和颞侧脉络膜厚度也降低。蛋白尿与眼轴长度之间存在轻度正相关（r = 0.282，p = 0.045）。
FMF中的亚临床炎症可能导致眼部早期结构变化，并可能随时间进展。这些发现强调了对儿科FMF患者进行长期眼科监测以更好地了解持续性炎症累积影响的重要性。
本研究使用SD-OCT评估了FMF患儿视乳头周围RNFL厚度和脉络膜血管结构，以评估亚临床炎症的眼部影响。研究发现，即使在病程相对较短的儿童中，慢性炎症也可能导致视网膜和脉络膜变薄。颞下象限视乳头周围RNFL厚度降低，并与血清淀粉样蛋白水平相关；此外，患者组脉络膜厚度显著更低，提示早期眼部受累及其作为亚临床全身炎症标志物的潜力。
