title: New aspect for systemic effects of COPD: eye findings.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) has multisystemic implications and comorbidities. Hypoxia and systemic inflammation are thought to involve oculary structures. In this study, our aim is to evaluate retinal nerve fiber and choroidal thickness and retinal vessel diameter using the spectral-domain optical coherence tomography (SD-OCT) in COPD subjects.
  
  
  METHODS
  Forty-three subjects diagnosed with COPD according to the Global Initiative for Chronic Obstructive Lung Disease criteria at the Pulmonology Department of Pamukkale University were enrolled in the study. All subjects underwent respiratory function testing and a carbon monoxide diffusion test. To determine hypoxic state, arterial blood gas analysis was performed. The control group consisted of 31 subjects with comparable age and gender distribution. All participants underwent a standard ophthalmic examination including visual acuity assessment, biomicroscopy, air-puff tonometry, indirect retinoscopy, and SD-OCT measurements.
  
  
  RESULTS
  The mean subfoveal choroidal thickness (SFCT), foveal thickness, and retinal arteriolar caliber were found to be similar in both groups, while the mean retinal venular caliber value was markedly higher in the COPD group. The mean peripapillary retinal nerve fiber layer (RNFL) thickness was 100.2±11.8 µm in the COPD group and 105.6 ± 8.1 µm in the control group (P = .03). The inferior quadrant RNFL was significantly thinner in the COPD group.
  
  
  CONCLUSIONS
  The results of this study showed increasing diameter of the retinal veins, thinning of the RNFL, and SFCT may be associated to chronic inflammation and hypoxia in subjects with COPD. Future guidelines may include ocular findings to the present systemic manifestations of COPD.
authors.affiliation: Department of Chest Diseases, Faculty of Medicine, Pamukkale University, Denizli, Turkey.
authors.forename: Erhan
authors.initials: E
authors.lastname: Ugurlu
authors.affiliation: Department of Ophthalmology, Pamukkale University, Denizli, Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Pekel
authors.affiliation: Department of Chest Diseases, Faculty of Medicine, Pamukkale University, Denizli, Turkey.
authors.forename: Goksel
authors.initials: G
authors.lastname: Altinisik
authors.affiliation: Department of Ophthalmology, Pamukkale University, Denizli, Turkey.
authors.forename: Kerem
authors.initials: K
authors.lastname: Bozkurt
authors.affiliation: Department of Chest Diseases, Faculty of Medicine, Pamukkale University, Denizli, Turkey.
authors.forename: Ilknur
authors.initials: I
authors.lastname: Can
authors.affiliation: Department of Chest Diseases, Faculty of Medicine, Pamukkale University, Denizli, Turkey.
authors.forename: Fatma
authors.initials: F
authors.lastname: Evyapan
mesh_terms: D002829:Choroid / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000473:pathology*; D012160:Retina / Q000473:pathology*; D041623:Tomography, Optical Coherence / Q000379:methods*; D014792:Visual Acuity
keywords: COPD; choroid; eye; lung disease; retinal artery; retinal vein