title: Aqueous flare and choroidal thickness in patients with chronic hepatitis C virus infection: a pilot study.
abstract: OBJECTIVE
  To investigate the status of the blood-aqueous barrier and to evaluate the subfoveal choroidal thickness (SCT) in patients with asymptomatic untreated chronic hepatitis C virus (HCV) infection without any anterior or posterior ocular involvement and to search for possible correlations.
  
  
  METHODS
  Observational case-control study.
  
  
  METHODS
  A total of 80 eyes of 20 HCV-positive patients (male-to-female ratio, 12:8; mean age, 46.9±7.23 years) and 20 healthy controls (male-to-female ratio, 10:10; mean age, 48.2±8.71 years) were examined.
  
  
  METHODS
  Participants underwent a complete ophthalmologic examination. Aqueous flare was quantified objectively by using the noninvasive laser flare cell meter FC-500 (Kowa Company Ltd, Tokyo, Japan), whereas SCT was evaluated by using enhanced depth imaging optical coherence tomography (Spectralis OCT; Heidelberg Engineering GmbH, Heidelberg, Germany). A Wilcoxon rank-sum test was performed to compare ocular findings between HCV patients and controls, and correlations were assessed by using the Spearman rank test.
  
  
  METHODS
  Retinal and choroidal thickness and anterior chamber inflammation of HCV patients and healthy controls.
  
  
  RESULTS
  Patients with HCV showed significantly higher aqueous flare values (8.37±2.25 photon counts/ms vs. 4.56±1.45 photon counts/ms; P<0.0001) and a significantly increased SCT (362.7±46.5 μm vs. 320.25±32.82 μm; P<0.0001) than healthy controls. Moreover, subjects with liver fibrosis had higher flare values than those with no significant hepatic fibrosis (9.62±1.99 photon counts/ms vs. 6.97±2.19 photon counts/ms; P = 0.0003) and thicker choroids (379.15±44.75 μm vs. 346.3±43.27 μm; P = 0.024). Statistical analysis revealed that there was a positive correlation between aqueous flare values and SCT in HCV patients (r = 0.69; P<0.0001) and between flare and the degree of liver fibrosis (r = 0.67; P = 0.0001).
  
  
  CONCLUSIONS
  This study showed that impairment of the blood-aqueous barrier and thickened choroids are features of asymptomatic HCV patients, and that choroidal thickness increases as the degree of subclinical inflammation of the anterior chamber increases. Patients with significant liver fibrosis have the highest flare values and the thickest choroids.
authors.affiliation: Ophthalmology Unit, Department of Experimental, Diagnostic, and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy. Electronic address: strobern@libero.it.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Strobbe
authors.forename: Mauro
authors.initials: M
authors.lastname: Cellini
authors.forename: Emilio C
authors.initials: EC
authors.lastname: Campos
mesh_terms: D000328:Adult; D001082:Aqueous Humor; D018916:Blood-Aqueous Barrier; D016022:Case-Control Studies; D002829:Choroid / Q000473:pathology*; D015828:Eye Infections, Viral / Q000175:diagnosis* / Q000821:virology; D005260:Female; D019698:Hepatitis C, Chronic / Q000175:diagnosis* / Q000821:virology; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D010865:Pilot Projects; D041623:Tomography, Optical Coherence; D014606:Uveitis, Anterior / Q000175:diagnosis* / Q000821:virology; D014792:Visual Acuity / Q000502:physiology