Shenavandeh Saeedeh, Afarid Mehrdad, Hasanaghaei Tarlaan, Nazarinia Mohammad Ali
Shiraz University of Medical Sciences, Department of Internal Medicine, Division of Rheumatology, Namazee Hospital, Shiraz, Iran.
Shiraz University of Medical Sciences, Departments of Ophthalmology, Poostchi Ophthalmology Research Center, Shiraz, Iran.
Reumatologia. 2021;59(1):27-34. doi: 10.5114/reum.2021.103436. Epub 2021 Feb 28.
Systemic sclerosis (SSc) is a connective tissue disease affecting the skin and multiple organs. Most of the evidence on ocular involvement comes from small studies. We evaluated the retinal vascular changes in patients with SSc and its associations with types, disease duration, skin score, and nailfold capillaroscopy changes.
We evaluated the demographic, clinical and nailfold capillaroscopy data of 52 patients referring to the clinic of scleroderma with SSc according to the 2013 ACR/EULAR SSc criteria. In addition, full ophthalmic examination in 52 patients and fundus photography in 40 patients were done in the ophthalmology clinic.
There were 52 (49 women and 3 men, 17 diffuse and 35 limited) patients with SSc with mean disease duration of 8 ±5 years and mean age of 40 ±9 years. Retinal changes in the ophthalmologic examination were seen in 30.7% as increased vascular tortuosity. None of the patients had cotton wool spot, hemorrhage or hard exudate. Forty patients underwent fundus photography and 22.5% of them had vascular tortuosity. Only the presence of hemorrhage in the nailfolds was correlated with retinal tortuosity, and the other characteristics of nailfold capillaroscopy did not have any association with retinal changes.
Retinal vascular changes were seen in about one third of our patients. There was no correlation between nailfold capillaroscopy, disease duration, type and skin score of SSc patients and retinal vascular changes. These findings suggest that the mechanisms or the quality of changes in the retinal vessels and nailfold vasculature may be different.
系统性硬化症（SSc）是一种影响皮肤和多个器官的结缔组织疾病。大多数关于眼部受累的证据来自小型研究。我们评估了SSc患者的视网膜血管变化及其与疾病类型、病程、皮肤评分和甲襞毛细血管镜检查变化的相关性。
我们根据2013年美国风湿病学会/欧洲抗风湿病联盟（ACR/EULAR）SSc标准，评估了52例到硬皮病门诊就诊的SSc患者的人口统计学、临床和甲襞毛细血管镜检查数据。此外，在眼科门诊对52例患者进行了全面眼科检查，对40例患者进行了眼底照相。
52例（49例女性和3例男性，17例弥漫型和35例局限型）SSc患者，平均病程8±5年，平均年龄40±9岁。眼科检查中30.7%的患者出现视网膜变化，表现为血管迂曲增加。所有患者均未出现棉絮斑、出血或硬性渗出。40例患者进行了眼底照相，其中22.5%有血管迂曲。仅甲襞出血与视网膜迂曲相关，甲襞毛细血管镜检查的其他特征与视网膜变化无任何关联。
约三分之一的患者出现视网膜血管变化。SSc患者的甲襞毛细血管镜检查、病程、类型和皮肤评分与视网膜血管变化之间无相关性。这些发现表明视网膜血管和甲襞血管变化的机制或性质可能不同。
