Osman ÇELİKAY, Tolga BİÇER, Mustafa KÖŞKER, Naciye KABATAŞ, Erman ÇAKAL, Canan GÜRDAL

GLUKOKİNAZ GEN MUTASYONU POZİTİF OLAN GENÇ ERİŞKİN DÖNEMDE BAŞLAYAN DİYABETLİ HASTALARDA KOROİD KALINLIĞI

AMAÇ: Glukokinaz (GCK) gen mutasyonu pozitif olan Genç Erişkin Dönemde Başlayan Diyabet (Maturity Onset Diabetes of Young - MODY) tanısı alan olgularla sağlıklı bireylerin koroid tabakası kalınlıklarının karşılaştırılması amaçlandı.GEREÇ VE YÖNTEM: MODY tanısı GCK gen mutasyonu bakılarak doğrulanmış olan ama diyabetik retinopatisi olmayan 30 hasta (MODY grubu) ve 30 sağlıklı kişi (kontrol grubu) çalışmaya dahil edildi. Kontrol grubu, MODY grubu ile yaş, cinsiyet, refraktif kusur ve aksiyel uzunluk açısından uyumlu seçildi. Koroid kalınlığı hastaların sağ gözünde foveada, foveadan 1500 μm ve 3000 μm uzaklıklarda nazalde ve temporalde RTVue-100 Fourier-domain optik koherens tomografi (OKT) kullanılarak ölçüldü.BULGULAR: MODY tanı zamanı 4.1±5.8 yıl (aralık; 0-17 yıl) idi. Ortalama HBa1c düzeyi 5.1 (aralık: 4.4-6.2, referans aralık: 4-6) iken hiçbir hastada diyabetik retinopati yoktu. Ortalama subfoveal koroid kalınlığı subfoveal alanda MODY grubunda 370.09± 86.66 μm iken kontrol grubunda 354.44 ± 76.70 μm idi (p=0.456). Koroid kalınlığı nazal 1500 μm’de (sırasıyla 300.75 ± 67.02 ve 296.13 ± 73.45 μm, p=0.672), nazal 3000 μm’de (184.56 ± 45.53 ve 192.94 ± 57.63 μm, p=0.485), temporal 1500 μm’de (325.16 ± 59.41 ve 299.59 ± 67.81 μm, p=0.093) ve temporal 3000 μm’de (261.88 ± 43.30 ve 256.75 ± 50.83 μm, p=0.582) istatistiksel anlamlı değişiklikler göstermedi.SONUÇ: Literatürde diyabetin koroid üzerine etkilerini araştıran birçok çalışma olmasına rağmen, bu çalışma spesifik olarak MODY’li hastalarda koroid kalınlığının değerlendirildiği ilk çalışmadır. Diyabetik retinopatisi olmayan MODY’li hastalarda koroid kalınlığı etkilenmeyebilir. Bu MODY’li hastaların genç olmasına, MODY süresinin kısa olmasına ve diyabet regülasyonunun iyi olmasına bağlanabilir.

Anahtar Kelimeler:

Genç erişkin başlangıçlı diyabet, Koroid kalınlığı, Diyabetik retinopati.

CHOROIDAL THICKNESS IN PATIENTS OF MATURITY ONSET DIABETES OF THE YOUNG WITH POSITIVE GLUCOKINASE GENE MUTATION

OBJECTIVE: The aim of this study was to compare the choroi-dal thickness (CT) of patients diagnosed with maturity onset di-abetes of young (MODY) with positive glucokinase (GCK) gene mutation with healthy individuals.MATERIAL AND METHODS: Thirty patients (MODY group) and and 30 healthy individuals (control group) whose diagnosis of MODY was confirmed by looking for GCK gene mutation but without diabetic retinopathy were included in this study. The control group was selected to be compatible with the MODY group for age, sex, refractive error and axial length. The choroidal thickness was measured at the fovea in the right eye of the patients, 1.5 mm and 3 mm away to the fovea in nasal and temporal side using RTVue-100 Fourier-domain optical coherence tomography (OCT).RESULTS: MODY diagnosis time was 4.1±5.8 years (range; 0- 17 years). While the average HBa1c levels were 5.1 (range:4.4-6.2, reference range:4-6), none of the patients were diagnosed with diabetic retinopathy. The mean subfoveal CT was 370.09 ± 86.66 μm in the MODY group and 354.44 ± 76.70 μm in the control group (p=0.456). The choroidal thickness at nasal 1.5 mm (300.75 ± 67.02 and 296.13 ± 73.45 μm respectively, p=0.672), nasal 3 mm (184.56 ± 45.53 and 192.94 ± 57.63 μm respectively, p=0.485), temporal 1.5 mm (325.16 ± 59.41 and 299.59 ± 67.81 μm respectively, p=0.093), and temporal 3 mm (261.88 ± 43.30 and 256.75 ± 50.83 μm respectively, p=0.582) did not show statistically significant changes.CONCLUSIONS: Although there have been lots of studies which examined the effects of diabetis on choroidal changes in the literature, this study is the first to specifically evaluate choroidal thickness in patients with MODY. The CT may not be affected in MODY patients without diabetic retinopathy. This can be attributed to the fact that the patients with MODY are young, the duration of MODY is short and diabetes regulation is good.

Keywords:

Maturity onset diabetes of young, Choroidal thickness, Diabetic retinopathy,

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