P257 Relationship between ocular vascular changes, malondialdehyde and vascular endothelial growth factor levels in inflammatory bowel disease
N. Sengul Samanci1, S. Poturoglu2, C. Samanci3, A. E. Duman*2, A. Ciftcibasi Ormeci2
1Haseki Training and Research Hospital, Internal Medicine, Istanbul, Turkey, 2Haseki Training and Research Hospital, Gastroenterology, Istanbul, Turkey, 3Istanbul University Cerrahpasa Medical Faculty, Department of Radiology, Istanbul, Turkey
Oxidative stress and angiogenesis may play a role in the pathogenesis of ophthalmic complications in inflammatory bowel disease (IBD). In this study, we aimed to determine ocular hemodynamic changes, malondialdehyde (MDA) and vascular endothelial growth factor (VEGF) levels in patients with ulcerative colitis (UC) or Crohn’s disease (CD) and to investigate the correlation between these parameters
We analysed 56 eyes of 28 patients with CD, 62 eyes of 31 patients with UC, and 68 eyes of 34 healthy volunteers by ocular colour Doppler ultrasonography. Measurements of peak systolic velocity (PSV cm/sec) and end diastolic velocity (EDV cm/sec) and resistivity index (RI = [PSV−EDV]/PSV) for ophthalmic artery (OA) and the central retinal artery (CRA) were obtained. We measured MDA and VEGF levels in plasma samples of all patients and healthy control individuals and analysed their correlations with ocular findings.
When we compared plasma MDA and VEGF levels between patient and control groups, MDA levels were significantly higher in both UC and CD patients compared with the control group, VEGF levels were increased only in CD group (p = 0.003, p < 0.001, p = 0.01, respectively). MDA levels were significantly higher in CD patients than UC group (p = 0.011). In Doppler ultrasonography measurements, PSV and EDV of OA were significantly lower in patients with CD compared with controls (p = 0.017, p = 0.001, respectively). RI of OA was significantly lower in control group than CD and UC groups (p < 0.01). There was not a statistically significant difference in PSV of CRA between groups (p > 0.05). EDV of CRA was significantly lower in CD patients compared with UC and controls (p = 0.014, p < 0.001, respectively). RI of CRA was significantly higher in patients with CD than in the UC and control groups (p = 0.011, p < 0.001, respectively). There was a positive correlation between PSV of CRA and MDA levels only in CD patients (r = 0.289, p = 0.046).
In patients with CD, there is a decrease in blood flow in both OA and CRA along with an increase in RI. No significant change in blood flow was noted in patients with UC. A positive correlation with MDA and PSV of CRA was found only in patients with CD. There was no other correlation between MDA, VEGF levels, and ocular hemodynamics. Ocular vascular flow was affected only in CD, which cannot be explained by just altered levels of MDA and VEGF; some other contributing factors may also play a role. This study shows that ocular ischaemia may occur in patients with CD even in the absence of any clinical finding.