Evaluation of eye involvement in paediatric celiac disease patients
Selim Dereci1, Abdulvahit Asik2, Ilke Direkci3
1Pediatric Gastroenterology, Faculty of Medicine, Adıyaman University, Adiyaman, Turkey.
Insights
Children with celiac disease (CeD) show thinner choroids, a finding persistent after a gluten-free diet. Further research is needed to understand the long-term implications of this ocular finding in pediatric celiac disease.
Area of Science:
- Ophthalmology
- Pediatrics
- Gastroenterology
Background:
- Non-classic celiac disease (CeD) presentations are common in children.
- Awareness of potential eye findings in pediatric CeD is crucial for early diagnosis and management.
- Ocular manifestations may be linked to CeD, necessitating further investigation.
Purpose of the Study:
- To evaluate ocular involvement in pediatric celiac disease (CeD) patients.
- To assess the effect of a gluten-free diet on ocular changes in children with CeD.
- To measure choroidal and ganglion cell complex (GCC) layer thicknesses using enhanced depth imaging optical coherence tomography (EDI-OCT).
Main Methods:
- Compared 43 pediatric CeD patients (4-16 years) with 48 healthy children.
- Conducted comprehensive eye examinations and EDI-OCT to measure choroidal and GCC layer thicknesses.
- Measurements were performed by blinded technicians and ophthalmologists after one year on a gluten-free diet for CeD patients.
Main Results:
- Significantly thinner choroidal layers (subfoveal, nasal, temporal) were observed in CeD patients compared to controls (P < .001).
- No significant differences in ganglion cell complex (GCC) layer thicknesses were found between CeD and control groups (P > .05).
Conclusions:
- Pediatric celiac disease leads to choroidal thinning, evident even after one year of a gluten-free diet.
- Ocular screening for thin choroid is recommended at CeD diagnosis; long-term clinical outcomes require further study.
- GCC layer thickness did not differ, suggesting potential dietary effects or lack of involvement.
Background:
The non-classic presentation of paediatric celiac disease (CeD) becomes increasingly common in daily practice, which requires an awareness of eye findings. The purpose of this study was to evaluate eye involvement and effect of gluten-free diet on ocular involvement in paediatric CeD patients by measuring the thicknesses of choroid and ganglion cell complex (GCC) composed of retinal nerve fibre layer, ganglion cell layer and inner plexiform layer using enhanced depth imaging optical coherence tomography.
Methods:
Forty-three CeD 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 (retinal nerve fibre layer at five points, ganglion cell layer and inner plexiform layer) were obtained using enhanced depth imaging optical coherence tomography. Measurement of thicknesses of choroid and GCC layers by a trained optical coherence tomography technician and an ophthalmologist who were not aware about group of children in paediatric CeD patients with 1 year gluten-free diet was carried out.
Results:
All layers of subfoveal, nasal and temporal choroid were significantly thinner in CeD than in the control group (P < .001, all, respectively). No significant difference was observed between the CeD and control groups in terms of GCC thicknesses (P > .05, all, respectively).
Conclusion:
Paediatric CeD caused thinning of subfoveal, nasal and temporal areas of choroid, and this change is apparent even after 1 year gluten-free diet. This eye involvement should be more closely screened at diagnosis, and long-term clinical results of thin choroid should be determined. Thicknesses of GCC layers were not different in CeD group and may reveal the effect of diet or not involvement.
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