SAT0408 Anti Tnf-α Therapy Provides Beneficial Effects on Choroidal Thickness Increase in Patients with Active Ankylosing Spondylitis: A Possible Mechanism of Infliximab Effectiveness in Suppressing Uveitis Attacks

Abstract

BackgroundPatients with ankylosing spondylitis (AS) have higher choroidal thickness values (CT) compared to controls.ObjectivesTo quantitatively asses the profile of CT in patients with AS using optical coherence tomography (OCT), and to examine whether the posterior eye segment abnormalities in active AS patients were reversible by infliximab therapyMethodsThirty-one patients with AS receiving infliximab therapy and 24 healthy controls were enrolled. Patient's clinical and demographic characteristics were recorded. Using OCT, we performed retinal imaging and choroidal thickness measurements in AS patients before and after 6 months of infliximab therapy, and in healthy controls who returned 6 months after the first visit. We compared patients before versus 6 months after infliximab therapy, as well as controls.ResultsPatients with AS had higher CT (mean± SD; 347.5±114.4 μm) compared to healthy controls (322.1±62.8 μm) (p=0.283), although this did not reach statistical significance. At 6 months after the first measurement, the mean CT was significantly decreased (after treatment with infliximab: 326.5±99.7μm vs. before: 347.5±114.4 μm, n=31, p=0.018) in AS group, but not in the control group (p=0.102). Retinal nerve fiber layer was significantly decreased at 6 months after treatment with infliximab in AS group (106.4±13.5 μm vs 105.0±13.0μm p=0.008).ConclusionsThis is the first study to evaluate the posterior eye segment in patients with AS using OCT. Our data indicate that CT abnormalities in active AS is reversible by therapy, and this CT decreasing effect of infliximab may be involved in its effective suppressing action of uveitis attacks in AS.ReferencesBalaskas K, Ballabeni P, Guex-Crosier Y. Retinal thickening in HLA-B27-associated acute anterior uveitis: evolution with time and association with severity of inflammatory activity. Invest Ophthalmol Vis Sci. 2012 14;53(10):6171–7.Kola M, Kalkışım A, Karkucak M, Turk A, Capkın E, Can I, Serdar OF, Mollamehmetoglu S, Ayar A. Evaluating of choroid thickness in Ankylosing spondylitis using optical coherence tomography. Ocular immunology and inflammation. 2014, 22(6):434–8.Disclosure of InterestNone declared

Measuring Choroid Thickness as a Marker of Systemic Inflammation in Patients With Ankylosing Spondylitis

“…Karkucak et al compared CT in 31 patients with active AS and in 24 healthy subjects. Choroidal thickness was thicker in the patient group, although the difference was not statistically significant 22 . As the study did not include a sample size calculation, it may have been underpowered due to the difference between group sample sizes.…”

“…Choroidal thickness was thicker in the patient group, although the difference was not statistically significant. 22 As the study did not include a sample size calculation, it may have been underpowered due to the difference between group sample sizes. Conversely, the present study compared biological treatment-naive patients with healthy subjects who were matched by factors known to affect CT. 13 Under these conditions, our results provide robust confirmation that the choroid is thicker among patients with AS than in healthy subjects.…”

Choroidal Thickness Is a Biomarker Associated With Response to Treatment in Ankylosing Spondylitis

“…Mean CT was significantly decreased after 6 months (CTat baseline was 347.5 ± 114.4 μm, CTafter 6 months was 326.5 ± 99.7 μm; p = 0.018). 25 Kola et al 2 found no correlation between CT and BASDAI or disease duration in AS patients.…”

“…Previous reports support our findings. Karkucak et al 25 evaluated CT in 31 patients with active AS at baseline and after 6 months of infliximab treatment. Mean CT was significantly decreased after 6 months (CT at baseline was 347.5 ± 114.4 μm, CT after 6 months was 326.5 ± 99.7 μm; p = 0.018) 25 .…”

“…Karkucak et al 25 evaluated CT in 31 patients with active AS at baseline and after 6 months of infliximab treatment. Mean CT was significantly decreased after 6 months (CT at baseline was 347.5 ± 114.4 μm, CT after 6 months was 326.5 ± 99.7 μm; p = 0.018) 25 . Kola et al 2 found no correlation between CT and BASDAI or disease duration in AS patients.…”