Título / Title

RETINAL AVASCULAR FOVEAL ZONE AS AN SYSTEMIC BIOMARKER TO EVALUATE INFLAMMATORY BOWEL DISEASE CONTROL

Introdução / Purpose

Inflammatory bowel disease (IBD) is a systemic inflammatory disease classified as Crohn Disease (CD) or Ulcerative Colitis (UC), according to the portion of gastrointestinal tract commitment. It could present extra intestinal findings, such as fever, weight loss, arthralgia, mucocutaneous lesions, hepatic, renal and ophthalmological involvement.
Nowadays, clinical parameters and colonoscopy establish criteria to controlled or non-controlled disease, defining treatment. Our study objective was to compare Foveal Avascular Zone (FAZ) in patients with IBD between in remission and active diseases.

Material e Método / Methods

We evaluated 72 patients with IBD trough complete ophthalmological exam. Retinography, OCT/OCTA was performed with Topcon Triton. Macula and posterior pole were evaluated with binocular indirect ophthalmoscopy and Fundus Biomicroscopy. Avascular foveal zone was determined with manual delimitation of superficial retinal image at Angio OCT exam with image6.net software.
To establish disease activity we considered MAYO score, calpro levels, colonoscopy results and clinical parameters.
In all patients we blindly evaluated retinal parameters.

Resultados / Results

Participants mean age was 42.26 years, 28 male (38.88%) and 44 female (61.11%). 37 with diagnosis of CD (51.38%) and 35 patients with diagnosis of UC (48.61%). 25 patients (34.72%) with active disease and 47 (65.27%) with disease in remission.
We didn’t found statistically difference in FAZ comparison between CD and RCU groups (p 0.91 for right eye and p 0.76 for left eye), but statistically difference comparing FAZ between remission and active group (p 0.01 in right eye and p 0.02 in left eye).

Discussão e Conclusões / Conclusion

It's the first study that evaluate FAZ in IBD patients.
We speculate that decreased avascular foveal zone may occur due to vascular engorgement and due to increased systemic inflammation. It can help to determine IBD activity and spare invasive exames to follow up.

Palavras Chave

Retina, Inflammatory Bowel Disease, Optical Coherence Tomography, Optical Coherence Tomography angiography, Avascular Foveal Zone