Terheyden Jan Henrik, Petzinna Simon M, Burg Lara C, von der Emde Leon, Behning Charlotte, Jungblut Julie, Reinking Katharina, Holz Frank G, Ach Thomas, Wintergerst Maximilian W M, Schäfer Valentin S, Finger Robert P
Department of Ophthalmology, University Hospital of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
Department of Rheumatology and Clinical Immunology, Clinic of Internal Medicine III, University Hospital of Bonn, Bonn, Germany.
BMC Ophthalmol. 2025 Apr 14;25(1):201. doi: 10.1186/s12886-025-03997-x.
Giant cell arteritis (GCA) is a vasculitis of large and medium-sized vessels that causes severe ophthalmic complications. Timely diagnosis and disease monitoring may prevent permanent vision loss but biomarkers for early ocular involvement are scarce. This study evaluates early optical coherence tomography (OCT) and OCT angiography (OCTA) biomarkers of ocular involvement in newly diagnosed GCA.
Newly diagnosed GCA patients and similarly aged controls were enrolled. Participants underwent ocular examination, including OCT and OCTA imaging of the macula and optic disc. OCT metrics included macular ganglion cell layer (GCL) and peripapillary retinal nerve fiber layer (pRNFL) thickness. OCTA parameters included vessel density (VD), vessel skeleton density, and vessel diameter index (VDI). Associations between imaging biomarkers and GCA symptoms (ordinal GCA symptom score) were analyzed using age-adjusted regression models.
We recruited 23 newly diagnosed GCA patients and 27 controls. VD and VDI in the deep retinal capillaries were significantly higher in GCA compared to controls (p ≤ 0.027). In patients reporting ocular symptoms, GCL thickness, volume and pRNFL thickness were increased in 11%, 22% and 17% of Early Treatment Diabetic Retinopathy Study subfields compared to controls (p ≤ 0.04). Additionally, GCL and pRNFL thicknesses were associated with GCA symptoms (p ≤ 0.041).
OCT and OCTA imaging revealed structural and perfusion alterations in newly diagnosed GCA patients. Retinal microcirculation was altered, even regardless of the presence of ophthalmic symptoms. Structural changes correlated with systemic manifestations of GCA, suggesting a link between extracranial and intracranial involvement. Our findings underscore the potential diagnostic value of OCT and OCTA biomarkers for ocular involvement in GCA.
巨细胞动脉炎（GCA）是一种大中型血管的血管炎，可导致严重的眼科并发症。及时诊断和疾病监测可预防永久性视力丧失，但早期眼部受累的生物标志物稀缺。本研究评估新诊断的GCA患者眼部受累的早期光学相干断层扫描（OCT）和OCT血管造影（OCTA）生物标志物。
纳入新诊断的GCA患者和年龄相仿的对照组。参与者接受眼部检查，包括黄斑和视盘的OCT和OCTA成像。OCT指标包括黄斑神经节细胞层（GCL）和视乳头周围视网膜神经纤维层（pRNFL）厚度。OCTA参数包括血管密度（VD）、血管骨架密度和血管直径指数（VDI）。使用年龄调整回归模型分析成像生物标志物与GCA症状（GCA症状序数评分）之间的关联。
我们招募了23例新诊断的GCA患者和27例对照组。与对照组相比，GCA患者深层视网膜毛细血管中的VD和VDI显著更高（p≤0.027）。在报告有眼部症状的患者中，与对照组相比，早期糖尿病视网膜病变研究子区域中GCL厚度、体积和pRNFL厚度分别有11%、22%和17%增加（p≤0.04）。此外，GCL和pRNFL厚度与GCA症状相关（p≤0.041）。
OCT和OCTA成像显示新诊断的GCA患者存在结构和灌注改变。即使没有眼部症状，视网膜微循环也发生了改变。结构变化与GCA的全身表现相关，提示颅外和颅内受累之间存在联系。我们的研究结果强调了OCT和OCTA生物标志物对GCA眼部受累的潜在诊断价值。
