Anti Tnf-Alpha Therapy Provides Beneficial Effects On Choroidal Thickness Increase In Patients With Active Ankylosing Spondylitis: A Possible Mechanism Of Infliximab Effectiveness In Suppressing Uveitis Attacks

Background Patients with ankylosing spondylitis (AS) have higher choroidal thickness values (CT) compared to controls. Objectives To 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 therapy Methods Thirty-one patients with AS receiving infliximab therapy and 24 healthy controls were enrolled. Patient9s 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. Results Patients 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 ). Conclusions This 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. References Balaskas 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, Kalkisim A, Karkucak M, Turk A, Capkin 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 Interest None declared