系统性硬化症患者的视网膜微血管改变及氯喹治疗

Retinal microvasculature alteration in patients with systemic sclerosis and chloroquine treatment.

作者信息

Huang Tao, Liang Rong-Bin, Zhang Li-Juan, Shu Hui-Ye, Ge Qian-Min, Liao Xu-Lin, Wu Jie-Li, Su Ting, Pan Yi-Cong, Zhou Qiong, Shao Yi

机构信息

Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, China.

Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.

出版信息

Quant Imaging Med Surg. 2022 Oct;12(10):4885-4899. doi: 10.21037/qims-21-1166.

DOI:10.21037/qims-21-1166

PMID:36185048

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9511431/

Abstract

BACKGROUND

Retinal vascular abnormality is an important part of ocular systemic sclerosis (SSc), and long-term use of chloroquine can lead to retinal toxicity. This study was conducted to evaluate retinal microvascular changes using optical coherence tomography angiography (OCTA) in patients with SSc and SSc patients on long-term chloroquine treatment.

METHODS

Fifteen SSc patients without chloroquine (30 eyes), 15 SSc patients taking long-term chloroquine (30 eyes) and 15 healthy controls (30 eyes) were recruited to this cross-sectional study. OCTA was used to examine the superficial and deep retinal capillary plexus in the macular retina of each eye. The densities of microvessels (MIR), macrovessels (MAR) and total microvessels (TMI) in the superficial and deep retina of the three groups were calculated and compared. We used the hemisphere segmentation method [superior right (SR), superior left (SL), inferior left (IL), and inferior right (IR)] and Early Treatment Diabetic Retinopathy Study (ETDRS) method [right (R), superior (S), left (L), and inferior (I)] to analyze changes in retinal microvascular density.

RESULTS

The superficial and deep retinal MIR density in SSc patients decreased (P<0.05) compared with the healthy control group. This significant difference was found in both superficial and deep layers in S, L, SR, SL and IL regions (P<0.05), and additionally in the R and I regions in the superficial layer (P<0.05). Similarly, compared with SSc patients who did not take chloroquine, the superficial and deep retinal MIR density of SSc patients on long-term chloroquine also decreased (P<0.05). This significant difference was found in both superficial and deep layers in R, I and IL regions (P<0.05), and additionally in the IR region in the superficial layer (P<0.05).

CONCLUSIONS

The OCTA results suggest that retinal MIR density is decreased in SSc patients, and that long-term use of chloroquine will aggravate this damage, resulting in a further decrease in retinal MIR density.

摘要

背景

视网膜血管异常是系统性硬化症（SSc）眼部病变的重要组成部分，长期使用氯喹可导致视网膜毒性。本研究旨在利用光学相干断层扫描血管造影（OCTA）评估SSc患者以及长期接受氯喹治疗的SSc患者的视网膜微血管变化。

方法

本横断面研究纳入了15例未服用氯喹的SSc患者（30只眼）、15例长期服用氯喹的SSc患者（30只眼）和15例健康对照者（30只眼）。使用OCTA检查每只眼睛黄斑视网膜的浅表和深层视网膜毛细血管丛。计算并比较三组患者浅表和深层视网膜的微血管密度（MIR）、大血管密度（MAR）和总微血管密度（TMI）。我们采用半球分割法[右上（SR）、左上（SL）、左下（IL）和右下（IR）]以及糖尿病视网膜病变早期治疗研究（ETDRS）方法[右（R）、上（S）、左（L）和下（I）]来分析视网膜微血管密度的变化。

结果

与健康对照组相比，SSc患者的浅表和深层视网膜MIR密度降低（P<0.05）。在S、L、SR、SL和IL区域的浅表和深层均发现了这一显著差异（P<0.05），此外在浅表层的R和I区域也有显著差异（P<0.05）。同样，与未服用氯喹的SSc患者相比，长期服用氯喹的SSc患者的浅表和深层视网膜MIR密度也降低（P<0.05）。在R、I和IL区域的浅表和深层均发现了这一显著差异（P<0.05），此外在浅表层的IR区域也有显著差异（P<0.05）。