Sir,

We have read and reviewed the article entitled ‘Evaluation of choroidal thickness in patients with scleroderma’ by Coskun et al1 with interest. The authors demonstrated that the patients with scleroderma had significantly thinner nasal, temporal, and subfoveal choroids compared with the healthy controls. The authors did not find any significant differences between the patients with limited-type and diffuse-type scleroderma in terms of subfoveal choroidal thickness (CT).

As it has been known and has been mentioned in the study, glaucoma may be seen in patients with scleroderma. Yamamoto et al2 found a significantly higher prevalence of normal-tension glaucoma (NTG) and primary open-angle glaucoma (POAG) in patients with scleroderma when compared with the normal controls. Allanore et al3 showed increased prevalence of ocular glaucomatous abnormalities in scleroderma. Therefore, we would like to ask the authors whether the patients included in the study had the data regarding cup/disc ratio and visual field, and whether the patients were analyzed for possible NTG and/or POAG.

Although the effect of IOP on CT is controversial, a number of studies in the literature indicated that it could have a significant effect on CT.4, 5 Saeedi et al4 demonstrated a negative correlation between mean CT and IOP.4 We also noted that IOP measurements and comparisons of the participants were not presented in the study.

A number of local and systemic physiological/ pathological conditions may affect CT.6 We wonder presence of any systemic diseases other than diabetes, history of the medications used for scleroderma or other diseases, use of alcohol or caffeinated or non-caffeinated beverages or smoking before OCT, and the systemic blood pressure measurements. It has been known that all those factors have significant effects on CT.6