Laptseva Natallia, Bitos Konstantinos, Rossi Valentina A, Nebunu Delia, Haider Thomas, Nägele Matthias P, Mihai Carina, Distler Oliver, Ruschitzka Frank, Sudano Isabella, Flammer Andreas J
Department of Cardiology, University Heart Center, University Hospital and University of Zurich, Zurich, Switzerland.
Department of Cardiology, University Heart Center, University Hospital and University of Zurich, Zurich, Switzerland; Center for Translational and Experimental Cardiology (CTEC), Department of Cardiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Microvasc Res. 2025 Mar;158:104780. doi: 10.1016/j.mvr.2024.104780. Epub 2024 Dec 19.
Systemic sclerosis (SSc) is a systemic autoimmune disease, characterized by widespread microvasculopathy and fibrosis. Vascular and endothelial cell changes appear to precede other features of SSc. Retinal vascular analysis is a new, easy-to-use tool for the assessment of retinal microvascular function. The primary aim of this study was to investigate whether retinal microcirculation is affected in patients with SSc compared to healthy controls.
Microvascular function was assessed non-invasively measuring flicker-light induced vasodilation of retinal arterioles (FIDart%). In addition, FID of retinal venules (FIDven%), central retinal arteriolar and venular equivalents (CRAE and CRVE), and measurements of flow-mediated vasodilation (FMD) of the brachial artery, pulse wave velocity (PWV) and pulse wave analysis were obtained. Patients with SSc were prospectively enrolled in the study (n = 40, mean age 56 ± 11 years, females 73 %) and compared with age- and sex-matched healthy controls (HC, n = 40; mean age 59 ± 15 years, females 73 %).
Patients with SSc showed significant impairment of retinal microvascular function compared to age- and gender-matched HC (FIDart%: 2.23 ± 2.0 % vs. 3.1 ± 1.9 %, respectively, p = 0.04). FMD and PWV were not significantly different between the groups. Impaired retinal microvascular function was associated with SSc disease duration.
Our study shows a significant impairment of retinal microvascular function in patients with SSc. Because this association seems to be independent of CV risk and dependent on disease duration, retinal vessel analysis may have the potential to serve as a tool for risk assessment and prognosis.
系统性硬化症（SSc）是一种系统性自身免疫性疾病，其特征为广泛的微血管病变和纤维化。血管及内皮细胞变化似乎先于SSc的其他特征出现。视网膜血管分析是一种用于评估视网膜微血管功能的新型、易用工具。本研究的主要目的是调查与健康对照相比，SSc患者的视网膜微循环是否受到影响。
通过非侵入性测量闪烁光诱导的视网膜小动脉血管舒张（FIDart%）来评估微血管功能。此外，还获取了视网膜小静脉的FID（FIDven%）、视网膜中央小动脉和小静脉等效值（CRAE和CRVE），以及肱动脉血流介导的血管舒张（FMD）、脉搏波速度（PWV）和脉搏波分析的测量值。SSc患者前瞻性纳入本研究（n = 40，平均年龄56±11岁，女性占73%），并与年龄和性别匹配的健康对照（HC，n = 40；平均年龄59±15岁，女性占73%）进行比较。
与年龄和性别匹配的HC相比，SSc患者的视网膜微血管功能显著受损（FIDart%：分别为2.23±2.0%和3.1±1.9%，p = 0.04）。两组之间FMD和PWV无显著差异。视网膜微血管功能受损与SSc疾病持续时间相关。
我们的研究表明SSc患者的视网膜微血管功能存在显著受损。由于这种关联似乎独立于心血管风险且依赖于疾病持续时间，视网膜血管分析可能有潜力作为一种风险评估和预后的工具。
