2.1 | Clinical setting
A total of 43 children with CD diagnosed and followed up at the Department of Pediatric Gastroenterology of Adıyaman University (Adıyaman,Turkey) were evaluated prospectively and compared with 48 controls who were recruited from the hospital well child outpatient clinic.
Diagnosis of CD is based on pathology results of biopsy material taken from the duodenum according to European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) diagnostic criteria.23
Measurement of thicknesses of choroid and GCC layers (the thickness of RNFL, GCL and IPL) of optic nerve by using EDI-OCT by a trained OCT technician and ocular examination of participants were made by an ophthalmologist who were not aware about group of children in pediatric CD patients with one year gluten free diet. Informed consent was obtained from all participants parents before procedures. The study was approved by hospital ethics committee (22.05.2018/4-4).
Systemic examinations and measurements of blood pressures were made in both groups and were within normal limits for age. All participants underwent comprehensive ocular examinations, including standard slit-lamp examination, refractive error evaluation and best-corrected visual acuity determination, intraocular pressure measurement with pulse tonometry, detailed fundoscopy and perimetry. Blood tests measuring hemoglobin, iron, vitamin D, vitamin B12, C-reactive protein, and sedimentation were within normal ranges in the CD and healthy control groups.
Children with; acute or chronic, and local or systemic, infection under four years of age who were unable to adapt to OCT, and the patients with corneal abnormality, intraocular pressure greater than 21 mm Hg, retinal disease, glaucoma, strabismus, optic disc disorder, history of ocular surgery or trauma, refraction error greater than 3 diopters and chronic use of any medication, were not included into the study.