Optical coherence tomography angiography: a window on systemic sclerosis microangiopathy.

Area of Science:

• Ophthalmology
• Rheumatology
• Medical Imaging

Background:

• Retinal vascular alterations are observed in systemic sclerosis (SSc), suggesting Optical Coherence Tomography Angiography (OCTA) can evaluate SSc-related microangiopathy.
• Microangiopathy in SSc affects small blood vessels, potentially impacting retinal health.

Purpose of the Study:

• To assess microangiopathic changes in the retina of SSc patients using OCTA.
• To correlate these retinal changes with clinical manifestations and capillaroscopic findings in SSc.

Main Methods:

• A case-control study comparing 41 SSc patients with 20 healthy controls.
• OCTA scans of the superficial and deep capillary plexuses (SCP and DCP) in the macula and optic nerve were acquired.
• Quantitative analysis included vascular density (VD), vascular length density (VLD), foveal avascular zone (FAZ), and retinal thickness.

Main Results:

• SSc patients exhibited significantly reduced VD and VLD in both SCP and DCP compared to controls (p < 0.001).
• Increased parafoveal retinal thickness was noted in SSc patients (p = 0.013) and correlated with nailfold capillaroscopy blood flow (p = 0.030).
• Foveal VD and VLD in the DCP were associated with avascular areas (p = 0.018, p = 0.019) and neoangiogenesis (p = 0.023, p = 0.025).

Conclusions:

• Ocular microangiopathy is an early finding in scleroderma patients.
• Retinal microangiopathic alterations in SSc are correlated with capillaroscopic findings.