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Retinal findings in systemic sclerosis: a comparison with nailfold capillaroscopic patterns
O Ushiyama1, K Ushiyama, T Yamada
1Department of Internal Medicine, Saga Medical School, Japan. ushiyama@post.saga-med.ac.jp
Annals of the Rheumatic Diseases
|February 21, 2003
Summary
Retinal disease is common in systemic sclerosis (SSc), affecting 34% of patients. These findings, including exudates and hemorrhages, may indicate vascular changes but differ from nailfold capillary damage.
Area of Science:
- Ophthalmology
- Rheumatology
- Vascular Medicine
Background:
- Systemic sclerosis (SSc) is a multisystem autoimmune disease characterized by vascular dysfunction, fibrosis, and immune dysregulation.
- Ocular manifestations, particularly retinal involvement, are increasingly recognized in SSc patients.
Purpose of the Study:
- To determine the prevalence and characteristics of retinal disease in patients with SSc.
- To investigate the association between retinal findings and clinical/laboratory parameters, including nailfold capillary abnormalities.
Main Methods:
- Ophthalmic fundus photography was performed and evaluated by masked ophthalmologists.
- Nailfold capillaries were assessed using dermoscopy.
- Patients were categorized into groups based on the presence or absence of retinal disease.
Main Results:
- The prevalence of retinal disease in SSc patients was 34%, significantly higher than the 8% in controls (p=0.011).
- Common retinal findings included hard exudates, vascular tortuosity, microhemorrhages, and macular degeneration.
- Patients with retinal disease had higher mean systolic blood pressure and age, but no significant difference in nailfold capillary damage was observed.
Conclusions:
- Retinal abnormalities are frequent in SSc and may represent characteristic vascular changes of the disease.
- The specific retinal changes observed in SSc may differ qualitatively from those seen in nailfold capillaries.