Advertisement

Subclinical ocular inflammation in patients with recurrent aphthous stomatitis

  • Betul Sereflican
    Correspondence
    Correspondence to Betul Sereflican, Bolu Abant Izzet Baysal University, Izzet Baysal Training and Research Hospital, Department of Dermatology, 14030 Golkoy, Bolu, Turkey.
    Affiliations
    Department of Dermatology, Izzet Baysal Training and Research Hospital, Bolu Abant Izzet Baysal University, Bolu, Turkey
    Search for articles by this author
  • Umit Dogan
    Affiliations
    Department of Ophthalmology, Izzet Baysal Training and Research Hospital, Bolu Abant Izzet Baysal University, Bolu, Turkey
    Search for articles by this author
Published:January 05, 2021DOI:https://doi.org/10.1016/j.jcjo.2020.12.005

      Abstract

      Objective

      Recurrent aphthous stomatitis (RAS) is the major finding of Behçet's disease as well as an inflammatory disease. We compared the choroidal thickness (CT) in patients with RAS with healthy volunteers.

      Methods

      Patients with RAS (n = 34) and age- and sex-matched controls (n = 34) were evaluated using spectral-domain optical coherence tomography (OCT). CT measurements were executed at 3 different points (subfoveal, nasal, and temporal). Laboratory parameters were determined for patients and controls.

      Results

      The mean subfoveal CT in the RAS and control groups were 356.7 ± 91.7 μm and 326.3 ± 86.6 μm, respectively. The RAS group demonstrated significantly higher subfoveal CT than the control group (p = 0.008).

      Conclusion

      This was the first reported study demonstrating a significantly higher subfoveal CT in patients with RAS. Further studies investigating the risk for subclinical ocular inflammation in this patient population are warranted.

      Objectif

      La stomatite aphteuse récurrente (SAR) est le principal symptôme de la maladie de Behçet et constitue en soi une atteinte inflammatoire. Nous avons comparé l’épaisseur de la choroïde (EC) chez des patients présentant une SAR à celle de volontaires sains.

      Méthodes

      On a eu recours à la tomographie par cohérence optique (OCT, pour optical coherence tomography) en domaine spectral pour évaluer les patients présentant une SAR (n = 34) et des sujets témoins appariés pour l’âge et le sexe (n = 34). L'EC a été mesurée dans 3 zones (sous-fovéale, nasale et temporale). Ont également été évalués les paramètres de laboratoire de l'ensemble des sujets.

      Résultats

      L’épaisseur sous-fovéale moyenne de la choroïde dans les groupes SAR et témoin se chiffrait respectivement à 356,7 ± 91,7 μm et à 326,3 ± 86,6 μm, mesure qui était significativement supérieure dans le groupe SAR, comparativement au groupe témoin (p = 0,008).

      Conclusion

      Il s'agissait de la première étude à mettre au jour une augmentation significative de l’épaisseur sous-fovéale de la choroïde en présence de SAR. Il serait important de réaliser d'autres études sur le risque d'inflammation oculaire subclinique au sein de cette population.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Canadian Journal of Ophthalmology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Akintoye S.O.
        • Greenberg M.S.
        Recurrent aphthous stomatitis.
        Dent Clin North Am. 2014; 58: 281-297
        • Slebioda Z.
        • Szponar E.
        • Kowalska A.
        Recurrent aphthous stomatitis: genetic aspects of etiology.
        Postepy Dermatol Alergol. 2013; 30: 96-102
        • McCullough M.J.
        • Abdel-Hafeth S.
        • Scully C.
        Recurrent aphthous stomatitis revisited; clinical features, associations, and new association with infant feeding practices?.
        J Oral Pathol Med. 2007; 36: 615-620
        • Keogan M.T.
        Clinical Immunology Review Series: an approach to the patient with recurrent orogenital ulceration, including Behcet's syndrome.
        Clin Exp Immunol. 2009; 156: 1-11
        • Bang D.
        • Hur W.
        • Lee E.S.
        • Lee S.
        Prognosis and clinical relevance of recurrent oral ulceration in Behcet's disease.
        J Dermatol. 1995; 22: 926-929
        • Alpsoy E.
        • Zouboulis C.C.
        • Ehrlich G.E.
        Mucocutaneous lesions of Behcet's disease.
        Yonsei Med J. 2007; 48: 573-585
        • Ozyurt K.
        • Celik A.
        • Sayarlioglu M.
        • Colgecen E.
        • Inci R.
        • Karakas T.
        • et al.
        Serum Th1, Th2 and Th17 cytokine profiles and alpha-enolase levels in recurrent aphthous stomatitis.
        J Oral Pathol Med. 2014; 43: 691-695
        • Accorinti M.
        • Pesci F.R.
        • Pirraglia M.P.
        • Abicca I.
        • Pivetti-Pezzi P.
        Ocular Behcet's disease: changing patterns over time, complications and long-term visual prognosis.
        Ocul Immunol Inflamm. 2017; 25: 29-36
        • Nickla D.L.
        • Wallman J.
        The multifunctional choroid.
        Prog Retin Eye Res. 2010; 29: 144-168
        • Iaccarino G.
        • Cennamo G.
        • Forte R.
        • Cennamo G.
        Evaluation of posterior pole with echography and optical coherence tomography in patients with Behcet's disease.
        Ophthalmologica. 2009; 223: 250-255
        • Scully C.
        • Porter S.
        Oral mucosal disease: recurrent aphthous stomatitis.
        Br J Oral Maxillofac Surg. 2008; 46: 198-206
        • Chaudhuri K.
        • Nair K.K.
        • Ashok L.
        Salivary levels of TNF-alpha in patients with recurrent aphthous stomatitis: a cross-sectional study.
        J Dent Res Dent Clin Dent Prospects. 2018; 12: 45-48
        • Tan K.A.
        • Gupta P.
        • Agarwal A.
        • Chhablani J.
        • Cheng C.Y.
        • Keane P.A.
        • et al.
        State of science: Choroidal thickness and systemic health.
        Surv Ophthalmol. 2016; 61: 566-581
        • Lee J.Y.
        • Lee D.H.
        • Lee J.Y.
        • Yoon Y.H.
        Correlation between subfoveal choroidal thickness and the severity or progression of nonexudative age-related macular degeneration.
        Invest Ophthalmol Vis Sci. 2013; 54: 7812-7818
        • Chung S.E.
        • Kang S.W.
        • Lee J.H.
        • Kim Y.T.
        Choroidal thickness in polypoidal choroidal vasculopathy and exudative age-related macular degeneration.
        Ophthalmology. 2011; 118: 840-845
        • Rewbury R.
        • Want A.
        • Varughese R.
        • Chong V.
        Subfoveal choroidal thickness in patients with diabetic retinopathy and diabetic macular oedema.
        Eye (Lond). 2016; 30: 1568-1572
        • Ahn S.J.
        • Woo S.J.
        • Park K.H.
        Retinal and choroidal changes with severe hypertension and their association with visual outcome.
        Invest Ophthalmol Vis Sc.i. 2014; 55: 7775-7785
        • Kola M.
        • Kalkisim A.
        • Karkucak M.
        • Turk A.
        • Capkin E.
        • Can I.
        • et al.
        Evaluation of choroidal thickness in ankylosing spondylitis using optical coherence tomography.
        Ocul Immunol Inflamm. 2014; 22: 434-438
        • Kilic R.
        • Kurt A.
        • Acer E.
        • Oktem C.
        • Kocamis O.
        Choroidal thickness in psoriasis.
        Int Ophthalmol. 2017; 37: 173-177
        • Turkcu F.M.
        • Sahin A.
        • Yuksel H.
        • Akkurt M.
        • Ucmak D.
        • Cinar Y.
        • et al.
        Evaluation of choroidal thickness in psoriasis using optical coherence tomography.
        Int Ophthalmol. 2016; 36: 851-854
        • Chung Y.R.
        • Cho E.H.
        • Jang S.
        • Lee S.Y.
        • Lee E.S.
        • Lee K.
        Choroidal thickness indicates subclinical ocular and systemic inflammation in eyes with Behcet disease without active inflammation.
        Korean J Ophthalmol. 2018; 32: 290-295
        • Coskun E.
        • Gurler B.
        • Pehlivan Y.
        • Kisacik B.
        • Okumus S.
        • Yayuspayi R.
        • et al.
        Enhanced depth imaging optical coherence tomography findings in Behcet disease.
        Ocul Immunol Inflamm. 2013; 21: 440-445
        • Kim M.
        • Kim H.
        • Kwon H.J.
        • Kim S.S.
        • Koh H.J.
        • Lee S.C.
        Choroidal thickness in Behcet's uveitis: an enhanced depth imaging-optical coherence tomography and its association with angiographic changes.
        Invest Ophthalmol Vis Sci. 2013; 54: 6033-6039
        • Yesilirmak N.
        • Lee W.H.
        • Gur Gungor S.
        • Yaman Pinarci E.
        • Akkoyun I.
        • Yilmaz G.
        Enhanced depth imaging optical coherence tomography in patients with different phases of Behcet's panuveitis.
        Can J Ophthalmol. 2017; 52: 48-53
        • Ishikawa S.
        • Taguchi M.
        • Muraoka T.
        • Sakurai Y.
        • Kanda T.
        • Takeuchi M.
        Changes in subfoveal choroidal thickness associated with uveitis activity in patients with Behcet's disease.
        Br J Ophthalmol. 2014; 98: 1508-1513
        • Park U.C.
        • Cho I.H.
        • Moon S.W.
        • Yu H.G.
        Long-term Change of subfoveal choroidal thickness in Behcet's disease patients with posterior uveitis.
        Ocul Immunol Inflamm. 2018; 26: 397-405
        • Karadag A.S.
        • Bilgin B.
        • Soylu M.B.
        Comparison of optical coherence tomographic findings between Behcet disease patients with and without ocular involvement and healthy subjects.
        Arq Bras Oftalmo.l. 2017; 80: 69-73
        • Linsenmeier R.A.
        • Padnick-Silver L.
        Metabolic dependence of photoreceptors on the choroid in the normal and detached retina.
        Invest Ophthalmol Vis Sci. 2000; 41: 3117-3123