Abstract
Background: The nonclassic presentation of pediatric celiac
disease (CD) becomes increasingly common in daily practice, which
requires an awareness of its extraintestinal clinical findings. To
evaluate eye involvement and effect of gluten free diet on ocular
involvement in pediatric CD 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 CD 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 CD patients with one year gluten free
diet.
Results: All layers of subfoveal, nasal, temporal choroid were
significantly thinner in CD than in the control group (p <
.001, p < .001, and p < .001, respectively). No
significant difference was observed between the CD and control groups in
terms of GCC thicknesses (p
> .05).
Conclusion: Pediatric CD causing thinning of subfoveal, nasal
and temporal areas of choroid, and this change is apparent even after
one year gluten free diet. This extraintestinal involvement should be
more closely screened at diagnosis and longterm clinical results of thin
choroid should be determined. Thicknesses of GCC layers were not
different in CD group may be revealing the effect of diet or not
involvement.
Keywords: Children, Celiac disease, choroid thickness, ganglion
cell complex, retinal nerve fiber layer, ganglion cell layer, inner
plexiform layer