Retino-Choroidal Changes In Patients With Acute Pancreatitis: A Prospective Analysis Of A Novel Biomarker

Background: There is paucity of data on ocular changes in acute Pancreatitis (AP). Moreover, subclinical alterations in retina & choroid have not been studied in AP.Objective: To prospectively study retino-choroidal changes in AP.Methods: Sixty patients (mean age 39.07 years; 41 males) with AP were followed up till recovery/death. Baseline slit-lamp examination, choroidal thickness (CT), retinal thickness (RT), choroidal vascularity index (CVI), retinal capillary density index (CDI) and arteriovenous ratio (AVR) were recorded. The patients were divided into two groups - mild (Group A; 5 patients) and moderately severe/severe (Group B; 55 patients) as per revised Atlanta classification.Results: Fundus examination showed mild optic disc edema with retinal hemorrhages in 6 (10%) patients in group B as compared to none in group A (p = 1.00). None of the patients had Purtscher retinopathy. Mean CT (317 +/- 56.29 mu m) was increased as compared to normal subjects (278.90 +/- 57.84 p = 0.003). The mean CVI (0.62 +/- 0.04) was decreased as compared to normal (0.66 +/- 0.01, p < 0.0001) as was the mean AVR (0.67 +/- 0.03 vs. 0.7 +/- 0.02, p < 0.0001). However, the mean RT of subjects with AP (239.68 +/- 33.76 mu m) was not significantly different compared to the normal subjects 253.17 +/- 33.67 mu m (p=NS). The mean CDI of superficial and deep plexus were comparable between normal and patients with AP. CT, RT, CVI, AVR and CDI were comparable between group A and group B as well as survivors and non-survivors.Conclusions: Clinically significant ocular changes are seen infrequently in AP. However, subclinical changes in CT, CVI and AVR are observed in patients with AP compared to normal individuals. (C) 2020 IAP and EPC. Published by Elsevier B.V. All rights reserved.