Retinal Vascular Abnormalities and Clinical Parameters in Systemic Sclerosis.

Area of Science:

• Ophthalmology
• Rheumatology
• Immunology

Background:

• Systemic sclerosis is an autoimmune disease with known vasculopathy, fibrosis, and immune dysregulation.
• Ocular manifestations are increasingly recognized, suggesting links between systemic vascular issues and ocular microvascular changes.
• Advanced imaging like optical coherence tomography (OCT) aids in understanding disease pathogenesis.

Purpose of the Study:

• To investigate vascular abnormalities in systemic sclerosis patients using OCT angiography (OCT-A).
• To correlate disease severity, assessed by molecular immunology and clinical markers, with OCT-A findings.
• To explore OCT-A as a tool for detecting ocular microvascular changes in systemic sclerosis.

Main Methods:

• Compared 32 systemic sclerosis patients with 9 healthy controls.
• Utilized OCT for retinal thickness and nerve fiber layer measurements.
• Employed OCT-A to assess vessel density (VD) in superficial (SCP) and deep capillary plexuses (DCP), foveal avascular zone (FAZ) size, and radial peripapillary capillary plexus (RPCP) VD.
• Assessed disease severity using modified Rodnan skin score (mRSS), capillaroscopy, and disease duration.

Main Results:

• Systemic sclerosis patients showed significantly reduced foveal and parafoveal retinal thickness, and decreased VD in the DCP and SCP compared to controls (p < 0.001).
• Patients exhibited a significantly enlarged FAZ (p = 0.005).
• No significant correlations were found between OCT/OCT-A parameters and disease severity scores.

Conclusions:

• OCT-A is a promising non-invasive tool for detecting retinal microvascular damage in systemic sclerosis.
• Findings suggest microvascular changes in the retina are present in systemic sclerosis.
• Further research can explore OCT-A's role in monitoring disease progression and treatment efficacy.