Altered microvasculature in patients with adult-onset dermatomyositis using optical coherence tomography angiography

To assess ocular microvascular vessel density (VD) in patients with adult-onset dermatomyositis (DM) measured by optical coherence tomography angiography (OCTA). 10 eyes of 10 patients with DM without interstitial lung disease were included in this cross-sectional study. All patients underwent ophthalmological and systemic evaluation, including nailfold capillaroscopy and OCTA examination (RTVue XR Avanti, Optovue Inc., Fremont, California, USA). The VD data of the 3 × 3 mm OCT angiogram of the superficial and deep capillary plexus (SCP, DCP), the choriocapillaris (CC) and radial peripapillary capillary density (RPC) of the optic nerve head (ONH) were extracted and analyzed. The data were compared with a gender- and age-matched healthy control group (10 eyes from 10 healthy individuals). The mean age of the patient group was 56.7 ± 3.11 years and 55.5 ± 10.76 years of the control group (p = 0.68) with 8 female and 2 male subjects per patient group and control group respectively. The VD in the inside disc area of the ONH was significantly reduced in the patient group compared to healthy controls (p = 0.028). A significant positive correlation was found between CC VD and nailfold capillary density (rₛₚ = 0.673, p = 0.033). This exploratory study identifies reduced VD in the ONH region of adult DM patients and suggests a link between ocular and systemic microvascular involvement. OCTA may offer non-invasive insights into microcirculatory changes in DM. Larger, longitudinal studies are warranted to validate these findings and evaluate the utility of OCTA-derived parameters as potential biomarkers in this rare disease.