Pieklarz Barbara, Gińdzieńska-Sieśkiewicz Ewa, Zawadzka Izabela, Bagrowska Magdalena, Daniluk Joanna, Sidorczuk Patryk, Kowal-Bielecka Otylia, Konopińska Joanna, Dmuchowska Diana Anna
Ophthalmology Department, Medical University of Białystok, Białystok, Poland.
Department of Rheumatology and Internal Diseases, Medical University of Białystok, Białystok, Poland.
Front Med (Lausanne). 2023 Oct 16;10:1273438. doi: 10.3389/fmed.2023.1273438. eCollection 2023.
Patients with systemic sclerosis (SSc) present an increased risk of developing glaucomatous optic neuropathy (GON). We investigated peripapillary choroidal parameters and peripapillary retinal nerve fiber layer (RNFL) thickness using spectral domain optical coherence tomography (SD-OCT) to determine the relationships of these factors with clinical variables.
A total of 33 patients with SSc were enrolled and compared to 40 controls. After obtaining circular scans around the optic disc, the global and quadrant peripapillary choroidal thickness (pCT) and RNFL thickness were measured. Additionally, the peripapillary choroidal vascularity index (pCVI), which allows for a quantitative analysis of the choroidal vasculature, was determined.
No significant differences were found in pCT and RNFL thickness between patients with SSc and controls, or within SSc subtypes (diffuse cutaneous systemic sclerosis (dcSSc) compared to limited cutaneous systemic sclerosis (lcSSc)) ( > 0.05). The pCVI was significantly lower in patients with SSc than in control subjects (64.25 ± 1.94 vs.65.73 ± 2.12, < 0.001).
Our results suggest that the statistically significant decrease in pCVI in patients with SSc compared to the control group is probably due to a decrease in the vascular layer, which would partially explain an increased risk of GON in patients with SSc.
系统性硬化症（SSc）患者发生青光眼性视神经病变（GON）的风险增加。我们使用光谱域光学相干断层扫描（SD-OCT）研究了视乳头周围脉络膜参数和视乳头周围视网膜神经纤维层（RNFL）厚度，以确定这些因素与临床变量之间的关系。
共纳入33例SSc患者，并与40例对照进行比较。在获得视盘周围的环形扫描后，测量视乳头周围脉络膜厚度（pCT）和RNFL厚度的整体及象限值。此外，还测定了视乳头周围脉络膜血管指数（pCVI），该指数可对脉络膜血管系统进行定量分析。
SSc患者与对照组之间，或SSc各亚型（弥漫性皮肤系统性硬化症（dcSSc）与局限性皮肤系统性硬化症（lcSSc）相比）之间，pCT和RNFL厚度均无显著差异（>0.05）。SSc患者的pCVI显著低于对照组（64.25±1.94对65.73±2.12，<0.001）。
我们的结果表明，与对照组相比，SSc患者的pCVI在统计学上显著降低可能是由于血管层减少，这可能部分解释了SSc患者发生GON风险增加的原因。
