Evaluation of Choroidal Vascularity Index and Its Association with Disease Activity in Sjögren's Syndrome: An...

Sjögren's syndrome (SS) is a chronic autoimmune disorder primarily affecting exocrine glands, although it may also involve multiple organs, including the eye. The choroid, the most vascularized ocular structure, is affected by systemic diseases. The choroidal vascularity index (CVI), a parameter that reflects vascular damage, decreases as vascular injury increases.

A total of 40 SS patients, aged 18-75 years, and 40 healthy controls were enrolled. Disease activity was assessed using the Sjögren's Syndrome Disease Activity Index (SSDAI); patients with an SSDAI score ≥5 were classified as having active disease, while those with scores <5 were considered in remission. Enhanced depth imaging optical coherence tomography (EDI-OCT) images were analyzed using ImageJ software to measure the luminal area (LA) and total choroidal area (TCA), with CVI calculated as the ratio LA/TCA.

SS patients exhibited significantly lower CVI values (mean: 0.62 ± 0.04) compared to controls (mean: 0.69 ± 0.02; p < 0.001). No significant correlation was found between CVI and SS disease activity as measured by the SSDAI. Additionally, CVI did not significantly differ with respect to gender, age, disease duration, anti-SS-A, anti-SS-B, or rheumatoid factor (RF) positivity. However, CVI was significantly lower in patients with positive antinuclear antibodies. In multivariable analysis, ANA positivity and CRP ≥5 mg/L were independently associated with lower CVI, whereas ESR showed no association with CVI.

Our findings indicate that SS patients exhibit reduced CVI, reflecting ocular vascular involvement, which was not associated with disease activity. As a non-invasive method, CVI measurement may serve as a useful tool for assessing microvascular damage induced by inflammatory processes.