Study on corneal morphology and correlation between corneal thickness and serum uric acid levels in gout

Background: Gout is an inflammatory metabolic disorder characterized by the accumulation of monosodium urate in extracellular spaces, especially joints. Its clinical characteristics include arthritis, nephrolithiasis, nephropathy, and tophi. Ocular tophi have been observed in the lateral canthus, up...

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Main Authors: Rishi Sharma, Jaya Kaushik, Ankita Singh, Aatish Saraswat, Sumit Goyal
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-12-01
Series:The Pan-American Journal of Ophthalmology
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Online Access:https://journals.lww.com/10.4103/pajo.pajo_93_24
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author Rishi Sharma
Jaya Kaushik
Ankita Singh
Aatish Saraswat
Sumit Goyal
author_facet Rishi Sharma
Jaya Kaushik
Ankita Singh
Aatish Saraswat
Sumit Goyal
author_sort Rishi Sharma
collection DOAJ
description Background: Gout is an inflammatory metabolic disorder characterized by the accumulation of monosodium urate in extracellular spaces, especially joints. Its clinical characteristics include arthritis, nephrolithiasis, nephropathy, and tophi. Ocular tophi have been observed in the lateral canthus, upper eyelid, orbit, iris, anterior chamber, subconjunctival space, and cornea. Good visual acuity requires a transparent cornea with healthy endothelial function and stromal layer organization. Reduced corneal transparency in gout patients may be a result of uric acid accumulation in the stroma or endothelial dysfunction. Aims and Objectives: This study aimed to investigate corneal endothelial cell density (ECD), morphology, and central corneal thickness (CCT) in gout patients compared to healthy individuals. Materials and Methods: A retrospective comparative study was conducted on 70 eyes of 35 gout patients and 70 eyes of 35 healthy subjects without gout or any other systemic disease. Detailed ophthalmologic examination was followed by specular microscopy where ECD, average cell area (ACA), coefficient of variation (CV), hexagonality ratio (HEX), and CCT values were recorded and analyzed in gout patients and healthy subjects. Results and Analysis: Mean ECD and HEX values were lower in the gout group than in the control group (P = 0.004 and P = 0.002). CV, standard deviation, ACA, maximum cell area, and CCT values were significantly higher in the gout group than in the control group (P = 0.001, P < 0.001, P = 0.007, P = 0.002, and P = 0.001). A significant positive correlation was found between uric acid levels and CCT (r = 0.355, P = 0.003). Conclusions: The study and monitoring of corneal morphology in gout patients and the correlation between corneal thickness and serum uric acid levels over time may provide insights into disease progression and modifications in drug therapy. Hence, ophthalmic evaluation should be incorporated in the comprehensive management of gout, especially in patients with unexplained ocular symptoms.
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spelling doaj-art-a3bc3880bf8f42ba93c835faa35353182025-01-14T08:40:24ZengWolters Kluwer Medknow PublicationsThe Pan-American Journal of Ophthalmology2666-49092024-12-0163454510.4103/pajo.pajo_93_24Study on corneal morphology and correlation between corneal thickness and serum uric acid levels in goutRishi SharmaJaya KaushikAnkita SinghAatish SaraswatSumit GoyalBackground: Gout is an inflammatory metabolic disorder characterized by the accumulation of monosodium urate in extracellular spaces, especially joints. Its clinical characteristics include arthritis, nephrolithiasis, nephropathy, and tophi. Ocular tophi have been observed in the lateral canthus, upper eyelid, orbit, iris, anterior chamber, subconjunctival space, and cornea. Good visual acuity requires a transparent cornea with healthy endothelial function and stromal layer organization. Reduced corneal transparency in gout patients may be a result of uric acid accumulation in the stroma or endothelial dysfunction. Aims and Objectives: This study aimed to investigate corneal endothelial cell density (ECD), morphology, and central corneal thickness (CCT) in gout patients compared to healthy individuals. Materials and Methods: A retrospective comparative study was conducted on 70 eyes of 35 gout patients and 70 eyes of 35 healthy subjects without gout or any other systemic disease. Detailed ophthalmologic examination was followed by specular microscopy where ECD, average cell area (ACA), coefficient of variation (CV), hexagonality ratio (HEX), and CCT values were recorded and analyzed in gout patients and healthy subjects. Results and Analysis: Mean ECD and HEX values were lower in the gout group than in the control group (P = 0.004 and P = 0.002). CV, standard deviation, ACA, maximum cell area, and CCT values were significantly higher in the gout group than in the control group (P = 0.001, P < 0.001, P = 0.007, P = 0.002, and P = 0.001). A significant positive correlation was found between uric acid levels and CCT (r = 0.355, P = 0.003). Conclusions: The study and monitoring of corneal morphology in gout patients and the correlation between corneal thickness and serum uric acid levels over time may provide insights into disease progression and modifications in drug therapy. Hence, ophthalmic evaluation should be incorporated in the comprehensive management of gout, especially in patients with unexplained ocular symptoms.https://journals.lww.com/10.4103/pajo.pajo_93_24corneal endothelial cell densitygoutocular tophispecular microscopyuric acid
spellingShingle Rishi Sharma
Jaya Kaushik
Ankita Singh
Aatish Saraswat
Sumit Goyal
Study on corneal morphology and correlation between corneal thickness and serum uric acid levels in gout
The Pan-American Journal of Ophthalmology
corneal endothelial cell density
gout
ocular tophi
specular microscopy
uric acid
title Study on corneal morphology and correlation between corneal thickness and serum uric acid levels in gout
title_full Study on corneal morphology and correlation between corneal thickness and serum uric acid levels in gout
title_fullStr Study on corneal morphology and correlation between corneal thickness and serum uric acid levels in gout
title_full_unstemmed Study on corneal morphology and correlation between corneal thickness and serum uric acid levels in gout
title_short Study on corneal morphology and correlation between corneal thickness and serum uric acid levels in gout
title_sort study on corneal morphology and correlation between corneal thickness and serum uric acid levels in gout
topic corneal endothelial cell density
gout
ocular tophi
specular microscopy
uric acid
url https://journals.lww.com/10.4103/pajo.pajo_93_24
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