Choroidal Thickness and Serum Asymmetric Dimethylarginine Levels in Patients with Systemic Sclerosis

Abstract

In addition to skin and visceral organ involvement, various ocular manifestations have also been described in patients with systemic sclerosis (SSc) or scleroderma. In recent years, optical coherence tomography (OCT) has been introduced into use as a beneficial imaging method in determining macular changes and in measuring choroidal thickness. Asymmetric dimethylarginine (ADMA) is a marker investigated in critical patients due to its proven reductive effect on nitric oxide synthesis. The present study aimed to evaluate serum ADMA levels and changes in choroidal thickness in SSc patients. The study included 20 adult SSc patients and 23 age-and sex-matched healthy subjects. Patients who had diabetes mellitus, hypertension, hypercholesterolemia, coronary heart disease, advanced-stage heart failure, renal failure, and a history of medication use and smokers and alcohol consumers were excluded. Patients’ demographic characteristics and medical histories were recorded. Choroidal thickness was measured using OCT in the right and left eyes of the patients and controls. ADMA levels were measured in the serum samples. The mean choroidal thickness was lower in the SSc group than in the control group; however, the difference reached the level of statistical significance only in nasal measurements (251.7±78.6 µm for the SSc patients and 279.2±50.7 µm for the control group; p=0.044). The ADMA level was found to be significantly higher in the SSc group than in the control group (0.545±0.130 µMol/L and 0.130±0.155 µMol/L, respectively; p=0.034). Based on the study outcomes, the serum ADMA level was significantly elevated in the SSc patients in the period when choroidal changes were not evident yet. A better understanding of the data about SSc etiopathogenesis and the role of ADMA in this process would make a contribution to the studies performed to develop new treatment strategies.