title: Spectral domain-optical coherence tomographic findings in patients with ankylosing spondylitis under anti-tumor necrosis factor-alpha therapy.
abstract: OBJECTIVE
  To evaluate the effect of tumor necrosis factor-alpha (TNF-α) blockade on the thickness of the peripapillary retinal nerve fiber layer (RNFL), the ganglion cell-inner plexiform layers (GCIPL), and the macula in ankylosing spondylitis (AS) patients under anti-TNF-α therapy.
  
  
  METHODS
  Twenty-one patients with AS received etanercept, or adalimumab, or infliximab for at least 6 months. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels, and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores were measured before and 6 months after the beginning of the treatment. Peripapillary RNFL, four regional fields (superior, inferior, nasal, and temporal), GCIPL, and macular thicknesses of the patients were analyzed by optical coherence tomography before the treatment, at 3 months and 6 months after the beginning of the treatment.
  
  
  RESULTS
  The mean BASDAI, ESR, and CRP values were 5.2 ± 1.5, 31.6 ± 21.7, and 15.7 ± 13.9, respectively, at the beginning of the treatment and 2.3 ± 1.7, 21.3 ± 15.1, and 10.1 ± 10.3, respectively, 6 months after the beginning of treatment. There were significant differences among the mean BASDAI, ESR, and CRP values at the beginning of treatment and 6 months later (p < 0.001, p = 0.007, and p = 0.009, respectively). There were no significant differences among peripapillary RNFL (p = 0.24), four regional fields (p = 0.98, p = 0.23, p = 0.09, p = 0.47), GCIPL (p = 0.25), or macular (p = 0.33) thicknesses of the patients during anti-TNF-α treatment. In addition, the mean intraocular pressure levels throughout the follow-up did not show significant variation on repeated-measures ANOVA (p = 0.77).
  
  
  CONCLUSIONS
  TNF-α blockade does not seem to influence RNFL, GCIPL, or macular thickness of patients with AS in the short term.
authors.affiliation: Department of Ophthalmology and.
authors.forename: Nilufer
authors.initials: N
authors.lastname: Ilhan
authors.forename: Nilgul
authors.initials: N
authors.lastname: Ustun
authors.forename: Esra Ayhan
authors.initials: EA
authors.lastname: Tuzcu
authors.forename: Mesut
authors.initials: M
authors.lastname: Coskun
authors.forename: Abdullah Erman
authors.initials: AE
authors.lastname: Yagiz
authors.forename: Ozgur
authors.initials: O
authors.lastname: Ilhan
authors.forename: Nihan
authors.initials: N
authors.lastname: Parlakfikirer
mesh_terms: D000068879:Adalimumab / Q000627:therapeutic use*; D000328:Adult; D000068800:Etanercept / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D000069285:Infliximab / Q000627:therapeutic use*; D008266:Macula Lutea / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D013167:Spondylitis, Ankylosing / Q000188:drug therapy* / Q000503:physiopathology; D041623:Tomography, Optical Coherence; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D014792:Visual Acuity
chemical_list: D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept
keywords: Macula lutea; retinal ganglion cell; spondylarthropathies