ABSTRACT
Purpose: To evaluate and compare choroidal thickness in patients with fibromyalgia (FM) and healthy controls. Methods: In this prospective, cross-sectional study, forty eyes of 40 patients with FM and 40 eyes of 40 age- and sex-matched healthy subjects were enrolled. FM was diagnosed according to the American College of Rheumatology criteria. The choroidal thickness measurements of the subjects were obtained using spectral-domain optical coherence tomography (RTVue-100, Optovue). Widespread pain index (WPI), symptom severity scale (SSS), and fibromyalgia impact questionnaire (FIQ) scores were recorded. The choroidal thickness measurements of the groups were compared, and correlations among the WPI, SSS, and FIQ scores and these measurements were calculated. Results: Choroidal thicknesses at 1500 ?m nasally were 198.5 ± 46.7 ?m and 306.3 ± 85.4 ?m; at 1000 ?m nasally were 211.7 ± 50.2 ?m and 310.05 ± 87.26 ?m; at 500 ?m nasally were 216 ± 55.05 ?m and 311.5 ± 83.4 ?m; at subfoveal region were 230.9 ± 58.4 ?m and 332.4 ± 91.3 ?m; at 500 ?m temporally 227.5 ± 58.1 ?m and 318.15 ± 92.3 ?m; at 1000 ?m temporally 224.5 ± 57.07 ?m and 315.1 ± 84.2 ?m; at 1500 ?m temporally 212.5 ± 56.08 ?m and 312.9 ± 87.8 ?m in the FM and control groups, respectively (P < 0.001). Choroidal thicknesses were thinner at all measurement location, except temporal 1000 and 1500 in patients with FIQ score ?50 than in FIQ score <50. Conclusion: The results of this study demonstrated that choroidal thickness decreases in patients with FM and correlated with disease activity. This choroidal changes might be related with the alterations in autonomic nervous system functioning. Further studies are needed to evaluate the etiopathologic relationship between choroidal thickness and FM.
ABSTRACT
ABSTRACT Purpose: To assess the effect of hemodialysis on retinal and choroidal thicknesses using spectral-domain optical coherence tomography (SD-OCT). Methods: In this prospective interventional study, 25 hemodialysis patients (17 male, 8 female) were enrolled. All participants underwent high-speed, high-resolution SD-OCT (λ=840 mm; 26.000 A-scans/s; 5 µm resolution) before and after hemodialysis. Choroidal thickness was measured perpendicularly from the outer edge of the retinal pigment epithelium to the choroid-sclera boundary at the fovea and at five additional points: 500 µm and 1000 µm nasal to the fovea and 500 µm, 1000 µm, and 1500 µm temporal to the fovea. Two masked physicians performed the measurements. Choroidal and retinal thicknesses before and after hemodialysis were compared. Results: The median choroidal thicknesses before and after hemodialysis were 182 µm (range, 103-374 µm) and 161 µm (range, 90-353 µm), respectively (P<0.001). The median retinal thicknesses were 246 µm (range, 179-296 µm) before and 248 µm (range, 141-299 µm) after hemodialysis (P>0.05). Systolic arterial pressure, diastolic arterial pressure, mean arterial pressure, heart rate, and ocular perfusion pressure significantly decreased after hemodialysis (P<0.001). Intraocular pressure did not vary significantly (P=0.540). Conclusion: Hemodialysis seems to cause a significant decrease in choroidal thickness, whereas it has no effect on retinal thickness. This significant decrease in choroidal thickness might be due to the extensive fluid absorption in hemodialysis, which could result in decreased ocular blood flow.
RESUMO Objetivo: Avaliar o efeito da hemodiálise (HD) na espessura da retina (RT) e na espessura da coroide (CT) usando tomografia de coerência óptica de domínio espectral (SD-OCT). Método: Neste estudo prospectivo intervencionista foram incluídos 25 pacientes em HD (17 homens e 8 mulheres). Todos os participantes foram submetidos a SD-OCT com dispositivo de alta resolução (λ=840 mm; 26.000 A-scans/seg e resolução de 5 µm), antes e após HD. A CT foi medida perpendicularmente a partir da borda externa do epitélio pigmentar da retina até o limite coroide-esclera na fóvea e em mais de 5 pontos localizados 500 µm nasal à fóvea, 1.000 µm nasal à fóvea; 500 µm temporal à fóvea, 1.000 µm temporal à fóvea, e 1.500 µm temporal à fóvea. Dois médicos realizaram as medidas sem o conhecimento do diagnóstico. Os dados da CT e RT, antes e após a HD foram comparados. Resultados: As CTs medianas antes e após a HD foram 182 µm (variação de 103-374 µm) e 161 µm (variação de 90-353 µm), respectivamente (p<0,001). A RT foi 246 µm (variação de 179-296 µm) antes e 248 µm (variação de 141-299 µm) após a HD (p>0,05). A pressão arterial sistólica, pressão arterial diastólica, as médias de pressão arterial média, frequência cardíaca e pressão de perfusão ocular diminuíram significativamente após HD (p<0,001). A pressão intraocular não alterou significativamente (p=0,540). Conclusão: A HD parece causar uma redução significativa da CT, e não ter efeito sobre a RT. Esta redução significativa da CT pode ser devida à grande absorção de fluido durante a HD, o que pode resultar numa diminuição do fluxo sanguíneo ocular.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Retina/anatomy & histology , Retina/diagnostic imaging , Choroid/anatomy & histology , Choroid/diagnostic imaging , Renal Dialysis/adverse effects , Organ Size , Reference Values , Retina/physiopathology , Time Factors , Observer Variation , Prospective Studies , Choroid/physiopathology , Statistics, Nonparametric , Tomography, Optical Coherence/methods , Eye/blood supply , Hemodynamics , Intraocular Pressure , Kidney Failure, Chronic/physiopathology , Kidney Failure, Chronic/therapyABSTRACT
Metastatic tumors of the stomach are very rare, with an incidence of 0, 2%- 0, 7% in the autopsy series. Malignant melanoma, carcinomas of breast, esophagus and lung are the most frequent primary tumor sites. The present case describes a 57-year-old woman who presented to the gastroenterology department with epigastric pain, nausea and vomiting for two months. Examinations revealed gastric metastasis of Renal Cell Carcinoma.