Turkiye Klinikleri Journal of Ophthalmology

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Alopesi Areata Hastalarında Kötü Prognostik Faktörlerin Oküler Yüzey Bulguları Üzerine Etkisi: Kesitsel Araştırma
Effect of Poor Prognostic Factors on Ocular Surface Findings in Alopecia Areata Patients: Cross-Sectional Research
Berire Şeyma DURMUŞ ECEa , Ümran ÖNERb
aKastamonu Üniversitesi Tıp Fakültesi, Göz Hastalıkları AD, Kastamonu, Türkiye
bKastamonu Üniversitesi Tıp Fakültesi, Dermatoloji AD, Kastamonu, Türkiye
Turkiye Klinikleri J Ophthalmol. 2024;33(4):203-9
doi: 10.5336/ophthal.2024-102677
Article Language: TR
Full Text
ÖZET
Amaç: Bu çalışmada, alopesi areata (AA) hastalarında oftalmolojik muayene sırasında saptanan bulguların ve oküler yüzey değişikliklerinin incelenmesi ve AA'nın kötü prognostik faktörlerinin kuru göz parametreleri üzerine etkisinin incelenmesi amaçlanmıştır. Gereç ve Yöntemler: Bu prospektif kesitsel çalışmaya AA hastaları ve sağlıklı kontroller dâhil edildi. Her iki gruba dermatolojik muayene, ön segment ve fundus muayenesi ve oküler yüzey değerlendirmesi amacıyla gözyaşı kırılma zamanı (GKZ) ve Schirmer testi ölçümleri gerçekleştirildi. AA hastalarında kötü prognostik faktörler pozitif aile öyküsü, juvenil başlangıç, uzun süreli hastalık (≥12 ay), atopi ve tırnak tutulumu varlığı olarak belirlendi. AA hastaları ile sağlıklı kontroller arasında ve kötü prognostik faktörü olan ve olmayan hasta gruplarında oküler yüzey parametreleri karşılaştırıldı. Bulgular: Çalışmaya 22 AA hastası ve 24 sağlıklı birey dâhil edildi. AA hastalarından yalnızca 2 hastada punktat lens opasitesi saptanırken hiçbir hastada fundus patolojisi saptanmadı. Lens değişikliği açısından AA hastaları ile sağlıklı kontroller arasında anlamlı farklılık saptanmadı (p>0,05). Ortalama GKZ değeri AA hastalarında sağlıklı kontrollere göre anlamlı düşük saptandı (7,5±2,2 sn'ye karşı 12,2±2,5 sn) (p<0,001). İki grup arasında Schirmer testi açsından anlamlı farklılık saptanmadı (p=0,129). AA hastaları arasında prognostik faktörlere göre yapılan karşılaştırmada, kötü prognostik faktörlere sahip hastalarda, kötü prognostik faktörü olmayan hastalara göre GKZ anlamlı düşük bulundu (6,5±1,9 sn'ye karşı 8,9±1,9 sn) (p<0,05). Sonuç: Sonuç olarak AA hastalarında sağlıklı kontrollere göre gözyaşı instabilitesinin olduğunu saptadık. Ayrıca kötü prognostik faktörlere sahip AA hastalarında GKZ değerinin anlamlı düşük olduğunu gösterdik. Özellikle kötü prognostik özelliklere sahip AA hastalarında oküler yüzey hastalıklarının erken tanı ve tedavisi açısından dikkatli bir yaklaşım öneriyoruz.

Anahtar Kelimeler: Alopesi areata; kuru göz sendromları; gözyaşı; lens; kristalin
ABSTRACT
Objective: This study aimed to examine the ocular findings and ocular surface changes detected during ophthalmological examination in patients with alopecia areata (AA) patients, and to examine the effects of poor prognostic factors in AA on dry eye parameters. Material and Methods: This prospective cross-sectional study included patients with AA and healthy controls. Both groups underwent dermatological examination, anterior segment and fundus examination, and ocular surface assessment, including tear breakup time (TBUT) and Schirmer test measurements. Poor prognostic factors in AA patients were defined as positive family history, juvenile onset, prolonged disease duration (≥12 months), presence of atopy, and nail involvement. Ocular surface parameters were compared between groups and between patient subgroups with and without poor prognostic factors. Results: The study included 22 patients with AA and 24 healthy individuals. Only 2 AA patients exhibited punctate lens opacities, and none of the patients showed any fundus pathology. There was no significant difference in lens changes between AA patients and healthy controls (p>0.05). The mean TBUT value was significantly lower in AA patients compared to healthy controls (7.5±2.2 vs. 12.2±2.5 seconds) (p<0.001). There was no significant difference in the Schirmer test between the two groups (p=0.129). In the comparison among AA patients based on prognostic factors, TBUT was significantly lower in patients with poor prognostic factors compared to those without poor prognostic factors (6.5±1.9 vs. 8.9±1.9 seconds) (p<0.05). Conclusion: In conclusion, in this study, tear instability was detected in AA patients compared to healthy controls. Additionally, a significant decrease in TBUT values was observed in AA patients with poor prognostic factors. We recommend a careful approach for the early diagnosis and treatment of ocular surface diseases, especially in AA patients with poor prognostic features.

Keywords: Alopecia areata; dry eye syndromes; tears; lens; crystalline
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