Selim Dereci1, Abdulvahit Asik2, Ilke Direkci3, Ayse Sevgi Karadag3, Samil Hizli4. 1. Pediatric Gastroenterology, Adıyaman University, Faculty of Medicine, Adiyaman, Turkey. 2. Pediatrics, Adiyaman University, Faculty of Medicine, Adiyaman, Turkey. 3. Ophthalmology, Adiyaman University, Faculty of Medicine, Adiyaman, Turkey. 4. Pediatric Gastroenterology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
Abstract
BACKGROUND: The non-classic presentation of pediatric celiac disease (CeD) becomes increasingly common in daily practice, which requires an awareness of eye findings. To evaluate eye involvement and effect of gluten free diet on ocular involvement in pediatric CeD patients by measuring the thicknesses of choroid and ganglion cell complex (GCC) composed of retinal nerve fiber layer (RNFL), ganglion cell layer (GCL) and inner plexiform layer (IPL) using enhanced depth imaging optical coherence tomography (EDI-OCT). METHODS: Forty-three CeD patients aged between four and 16 years (mean age;9.9 ± 4.1, 12 boys and 31 girls), and 48 healthy children (mean age; 11.3 ± 4.1,17 boys and 31 girls) were compared. Following comprehensive eye examinations, thicknesses of choroid at three points and GCC layers (RNFL at five points, GCL and IPL) were obtained using EDI-OCT. Measurement of thicknesses of choroid and GCC layers by a trained OCT technician and an ophthalmologist who were not aware about group of children in pediatric CeD patients with one year gluten free diet. RESULTS: All layers of subfoveal, nasal, temporal choroid were significantly thinner in CeD than in the control group (p< .001, all, respectively). No significant difference was observed between the CeD and control groups in terms of GCC thicknesses (p > .05, all, respectively). CONCLUSION: Pediatric CeD causing thinning of subfoveal, nasal and temporal areas of choroid and this change is apparent even after one year gluten free diet. This eye involvement should be more closely screened at diagnosis and long term clinical results of thin choroid should be determined. Thicknesses of GCC layers were not different in CeD group may be revealing the effect of diet or not involvement. This article is protected by copyright. All rights reserved.
BACKGROUND: The non-classic presentation of pediatric celiac disease (CeD) becomes increasingly common in daily practice, which requires an awareness of eye findings. To evaluate eye involvement and effect of gluten free diet on ocular involvement in pediatric CeD patients by measuring the thicknesses of choroid and ganglion cell complex (GCC) composed of retinal nerve fiber layer (RNFL), ganglion cell layer (GCL) and inner plexiform layer (IPL) using enhanced depth imaging optical coherence tomography (EDI-OCT). METHODS: Forty-three CeD patients aged between four and 16 years (mean age;9.9 ± 4.1, 12 boys and 31 girls), and 48 healthy children (mean age; 11.3 ± 4.1,17 boys and 31 girls) were compared. Following comprehensive eye examinations, thicknesses of choroid at three points and GCC layers (RNFL at five points, GCL and IPL) were obtained using EDI-OCT. Measurement of thicknesses of choroid and GCC layers by a trained OCT technician and an ophthalmologist who were not aware about group of children in pediatric CeD patients with one year gluten free diet. RESULTS: All layers of subfoveal, nasal, temporal choroid were significantly thinner in CeD than in the control group (p< .001, all, respectively). No significant difference was observed between the CeD and control groups in terms of GCC thicknesses (p > .05, all, respectively). CONCLUSION: Pediatric CeD causing thinning of subfoveal, nasal and temporal areas of choroid and this change is apparent even after one year gluten free diet. This eye involvement should be more closely screened at diagnosis and long term clinical results of thin choroid should be determined. Thicknesses of GCC layers were not different in CeD group may be revealing the effect of diet or not involvement. This article is protected by copyright. All rights reserved.