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类风湿关节炎患者的光学相干断层扫描视网膜血管造影特征:一项初步研究。

OCT retinal angiography features in patients with rheumatoid arthritis: A pilot study.

作者信息

Iacono Pierluigi, Da Pozzo Stefano, Bedendo Alberto, Arrigo Alessandro, Parravano Mariacristina, Varano Monica, Battaglia Parodi Maurizio

机构信息

IRCCS - Fondazione Bietti, Rome, Italy.

TS Retina, Trieste, Italy.

出版信息

Eur J Ophthalmol. 2022 Jul;32(4):2433-2439. doi: 10.1177/11206721211035626. Epub 2021 Jul 27.

Abstract

PURPOSE

To evaluate the superficial (SCP) and deep retinal capillary plexus (DCP) by mean of optical coherence tomography angiography (OCTA) in treatment-naïve patients affected by rheumatoid arthritis (RA).

METHODS

Between March 2019 and January 2020, patients with recent diagnosis of "definite RA" based on 2010 Rheumatoid Arthritis Classification Criteria were included in a Prospective, observational single center case-control study carried out at G.B. Bietti Foundation. Data were compared with those of 16 healthy age- and sex-matched subjects. Values of the vessel density (VD) of SCP and DCP, central foveal thickness (CFT), foveal avascular zone (FAZ) were collected by mean of OCTA. Main outcome measure was the VD alteration of SCP and DCP in treatment-naïve RA-patients.

RESULTS

No difference in age, sex-distribution, best-corrected visual acuity, CFT was registered between the two groups. OCTA data analysis showed in RA-patients a statistically significant reduction in the VD in the mean global area, inner ring, especially in the superior quadrant of the SCP. A trend of VD reduction was also registered in temporal, nasal, and inferior quadrants, respectively, although it did not reach a statistically significant value. Assessment of VD of DCP and FAZ area did not evidence any difference among the groups.

CONCLUSIONS

OCTA allows to highlight the vascular remodeling of the retinal microcirculation in RA-patients, even in early stages of the disease, demonstrating a reduction of VD. Outcomes of the current investigation can provide new insight in the pathogenetic mechanism of RA and extend the potential applications of this diagnostic tool.

摘要

目的

通过光学相干断层扫描血管造影(OCTA)评估初治类风湿关节炎(RA)患者的浅表视网膜毛细血管丛(SCP)和深部视网膜毛细血管丛(DCP)。

方法

2019年3月至2020年1月期间,基于2010年类风湿关节炎分类标准,近期诊断为“确诊RA”的患者被纳入在GB比耶蒂基金会开展的一项前瞻性、观察性单中心病例对照研究。将数据与16名年龄和性别匹配的健康受试者的数据进行比较。通过OCTA收集SCP和DCP的血管密度(VD)、中心凹厚度(CFT)、中心凹无血管区(FAZ)的值。主要观察指标是初治RA患者SCP和DCP的VD改变。

结果

两组之间在年龄、性别分布、最佳矫正视力、CFT方面无差异。OCTA数据分析显示,RA患者平均全局区域、内环的VD有统计学意义的降低,尤其是SCP上象限。颞侧、鼻侧和下象限也分别有VD降低的趋势,尽管未达到统计学显著值。DCP和FAZ区域的VD评估在各组之间未显示出任何差异。

结论

OCTA能够突出RA患者视网膜微循环的血管重塑,即使在疾病早期,表现为VD降低。本研究结果可为RA的发病机制提供新的见解,并扩展这种诊断工具的潜在应用。

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