Reduced retinal microvascular density in patients with mixed connective tissue disease: an exploratory pilot study on...

Area of Science:

• Ophthalmology
• Rheumatology
• Immunology

Background:

• Mixed connective tissue disease (MCTD) is an autoimmune disorder with overlapping symptoms of lupus, scleroderma, and myositis, typically marked by anti-U1-RNP antibodies.
• While retinal microvascular changes are known in other connective tissue diseases, data specific to MCTD patients are limited.

Purpose of the Study:

• To investigate subclinical retinal microvascular abnormalities in patients with Mixed Connective Tissue Disease (MCTD) using optical coherence tomography angiography (OCT-A).
• To explore potential correlations between retinal vascular changes and clinical parameters such as disease duration, renal function, and complement levels in MCTD.

Main Methods:

• A cross-sectional pilot study involving 20 MCTD patients and 20 age/sex-matched healthy controls (HC).
• Optical coherence tomography angiography (OCT-A) was used to assess retinal vessel density (VD) and foveal avascular zones (FAZs).
• Nailfold videocapillaroscopy (NVC) was performed on MCTD patients to evaluate microangiopathy patterns.

Main Results:

• MCTD patients exhibited significantly reduced superficial and deep retinal VD compared to HC.
• Deep retinal VD inversely correlated with disease duration and positively with estimated glomerular filtration rate (eGFR) in MCTD patients.
• Superficial parafoveal VD positively correlated with C3 complement levels in MCTD patients.
• NVC revealed microangiopathy in 60% of MCTD patients, but findings did not correlate with OCT-A results.

Conclusions:

• Subclinical retinal microvascular abnormalities are detectable in MCTD patients via OCT-A.
• Retinal vascular changes in MCTD may be associated with disease duration, renal function, and complement levels.
• OCT-A shows potential as a valuable tool for assessing vascular involvement in MCTD.