Department of Ophthalmology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.
Laboratory for Angiogenesis and Ocular Cell Transplantation, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.
Orphanet J Rare Dis. 2021 Jan 13;16(1):27. doi: 10.1186/s13023-020-01649-5.
To investigate the correlation between retinal and choroidal microperfusion in patients with systemic sclerosis (SSc) using optical coherence tomography angiography (OCTA).
In this cross-sectional study SSc patients without clinical evidence of ocular involvement and healthy, age- and sex-matched volunteers were recruited. Participants underwent specific rheumatological and ophthalmological examinations, including optical coherence tomography (OCT) and OCTA. Retinal and choroidal thicknesses as well as perfusion of the retina and the choroidal sublayers were evaluated.
A total of 15 SSc patients (30 eyes) with a median disease duration of 60 months and 15 matched, healthy controls (30 eyes) were recruited. OCT data revealed a significantly lower macular volume, as well as Sattler's layer and Haller's layer thickness in SSc patients compared to controls. In OCTA analysis, the perfusion of both retinal plexus as well as Sattler's and Haller's layer were significantly reduced in the SSc group. Patients with a disease duration of more than 60 months showed a statistically significant positive correlation between retinal and choroidal malperfusion, while those with a shorter disease duration did not.
OCTA analysis confirmed impairment of retinal and choroidal microperfusion in SSc patients, supporting the hypothesis of wide spreading vascular injury. In early stages, either the retinal or the choroidal perfusion seems to be involved, while later on, vascular impairment affects both tissues alike. Both, retinal and choroidal examinations should be considered as soon as the diagnosis of SSc is made, to avoid missing out on early alterations.
应用光学相干断层扫描血管造影术（OCTA）研究系统性硬化症（SSc）患者视网膜和脉络膜微循环的相关性。
本横断面研究纳入了无眼部受累临床表现的 SSc 患者和年龄、性别匹配的健康志愿者。所有参与者均接受了特定的风湿病学和眼科检查，包括光学相干断层扫描（OCT）和 OCTA。评估了视网膜和脉络膜的厚度以及视网膜和脉络膜各层的灌注情况。
共纳入了 15 例 SSc 患者（30 只眼），中位疾病病程为 60 个月，以及 15 名匹配的健康对照者（30 只眼）。OCT 数据显示，与对照组相比，SSc 患者的黄斑容积以及 Sattler 层和 Haller 层厚度显著降低。在 OCTA 分析中，SSc 组视网膜和脉络膜各层的灌注均显著减少。病程超过 60 个月的患者，视网膜和脉络膜灌注不良之间存在统计学上的正相关，而病程较短的患者则无此相关性。
OCTA 分析证实 SSc 患者存在视网膜和脉络膜微循环受损，支持广泛血管损伤的假说。在早期，要么是视网膜灌注，要么是脉络膜灌注受到影响，而在后期，血管损伤则同时影响这两种组织。一旦诊断出 SSc，就应考虑进行视网膜和脉络膜检查，以避免错过早期改变。
