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早期类风湿关节炎患者视网膜血管参数变化(通过光学相干断层扫描血管造影):一项基于医院的研究

Retinal Vascular Parameters Changes (by Optical Coherence Tomography Angiography) in Early Rheumatoid Arthritis: A Hospital-Based Study.

作者信息

Ebaid Amany M, Mekkawy Enas M, Mattout Hala K

机构信息

Rheumatology and Rehabilitation Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

Ophthalmology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

出版信息

Ocul Immunol Inflamm. 2025 Jul;33(5):812-818. doi: 10.1080/09273948.2025.2460642. Epub 2025 Feb 6.

Abstract

PURPOSE

To evaluate the retinal vascular changes related to early Rheumatoid Arthritis (RA) and to correlate these changes with disease activity.

METHODS

108 eyes of 54 early RA patients and 66 eyes of 33 age and sex-matched healthy participants underwent Optical Coherence Tomography Angiography (OCTA) examination to evaluate superficial (SCP), deep retinal capillary plexus (DCP), and radial peripapillary capillaries (RPC), we collected Values of the vessel density (VD) of SCP and DCP, central foveal thickness (CFT), foveal avascular zone (FAZ) along with a full rheumatological examination and disease activity score by (DAS28).

RESULTS

RPC values were significantly lower among RA patients in all subfields apart from the temporal one. There was a significant difference between RA patients and healthy controls in foveal and all perifoveal measurements, except the nasal perifoveal region. Also, the FAZ value was significantly higher in RA patients. We performed Spearman's correlation between OCTA and RA disease parameters and detected a negative correlation between the duration of disease-related symptoms and RPC and parafoveal measurements and between DAS-28 and foveal measurements. A significant positive correlation between anti-CCP titer and FAZ measurements was detected among RA patients.

CONCLUSION

OCTA can detect early retinal microcirculation affection in RA patients in the form of a reduction in the vascular density in most of the subfields of the peripapillary area as well as the fovea, perifoveal, and parafoveal areas. The results of the current study can provide new insight into the applications of OCTA as a diagnostic tool in RA patients' assessment and follow-up.

摘要

目的

评估与早期类风湿关节炎(RA)相关的视网膜血管变化,并将这些变化与疾病活动度相关联。

方法

对54例早期RA患者的108只眼和33名年龄及性别匹配的健康参与者的66只眼进行光学相干断层扫描血管造影(OCTA)检查,以评估浅表视网膜毛细血管丛(SCP)、深层视网膜毛细血管丛(DCP)和视乳头周围放射状毛细血管(RPC),我们收集了SCP和DCP的血管密度(VD)值、中心凹厚度(CFT)、中心凹无血管区(FAZ),同时进行了全面的风湿病检查和疾病活动度评分(DAS28)。

结果

除颞侧亚区外,RA患者所有亚区的RPC值均显著较低。RA患者与健康对照在中心凹及所有中心凹周围测量值(鼻侧中心凹周围区域除外)存在显著差异。此外,RA患者的FAZ值显著更高。我们对OCTA与RA疾病参数进行了Spearman相关性分析,发现疾病相关症状持续时间与RPC及中心凹旁测量值之间、DAS-28与中心凹测量值之间呈负相关。在RA患者中,抗环瓜氨酸肽(CCP)滴度与FAZ测量值之间存在显著正相关。

结论

OCTA能够检测到RA患者早期视网膜微循环受累,表现为视乳头周围区域以及中心凹、中心凹周围和中心凹旁区域的大部分亚区血管密度降低。本研究结果可为OCTA作为RA患者评估和随访的诊断工具的应用提供新的见解。

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