Vural Esra, Erol Kemal, Bayram Nurettin, Karahan Samet, Gündoğan Medine, Hazar Leyla
World Eye Hospital, Istanbul, Turkey.
Department of Rheumatology, Selçuk University Medicine Faculty, Konya, Turkey.
Int Ophthalmol. 2025 May 8;45(1):181. doi: 10.1007/s10792-025-03536-z.
To evaluate the choroidal structural components using central macular thickness (CMT), choroidal thickness (CT) and the choroidal vascular index (CVI) and compare the results between patients with systemic sclerosis (SSc), causing both fibrotic and angiopathic changes in tissues and healthy controls.
This prospective comparative study evaluated 22 patients with SSc (SSc group). The patients' choroidal thickness, CVI and choroidal area (CA) were compared with 21 healthy controls (control group). The patients' nailfold videocapillaroscopy (NVC) and modified Rodnan skin score (mRss) were evaluated by expert rheumatologists. In addition, the relationships between choroidal findings and NVC and mRss were assessed.
The central macular thickness in the SSc and control groups was 269.47 ± 26.78 µm and 261.19 ± 17.09 µm, respectively (p = 0.093). The subfoveal choroidal thickness was 295.38 ± 33.70 μm and 322.16 ± 70.24 μm, respectively (p = 0.026); the temporal choroidal thickness was 246.77 ± 21.83 μm and 265.26 ± 52.34 μm, respectively (p = 0.034); and the nasal choroidal thickness was 135.36 ± 28.10 μm and 158.88 ± 49.16 μm, respectively (p = 0.008). Total CA of 1.5 mm region centered on the fovea was 0.49 ± 0.08 mm and 0.55 ± 0.09 mm, respectively (p = 0.002); total CVI of 1.5 mm region centered on the fovea was 63.66% ± 1.23 and 64.90% ± 1.07, respectively (p < 0.001); total CA of 6 mm region centered on the fovea was 1.61 ± 0.22 mm and 1.80 ± 0.33 mm, respectively (p = 0.003); the total CVI of 6 mm region centered on the fovea was 63.85% ± 1.16 and 64.87% ± 1.12, respectively (p < 0.001). There was no correlation between mRss score and Raynaud severity and CMT, CVI and CTs; however, there was a positive correlation between the mRss and the Raynaud severity (p = 0.0004, r = 0.507).
This study found that choroidal thickness and CVI decreased in SSc patients. A decrease in CVI may be an indicator of damage, especially in luminal structures.
使用中心黄斑厚度（CMT）、脉络膜厚度（CT）和脉络膜血管指数（CVI）评估脉络膜结构成分，并比较系统性硬化症（SSc）患者与健康对照者的结果，SSc会导致组织发生纤维化和血管病变。
这项前瞻性比较研究评估了22例SSc患者（SSc组）。将患者的脉络膜厚度、CVI和脉络膜面积（CA）与21名健康对照者（对照组）进行比较。由专业风湿病学家评估患者的甲襞微血管造影（NVC）和改良Rodnan皮肤评分（mRss）。此外，评估脉络膜检查结果与NVC和mRss之间的关系。
SSc组和对照组的中心黄斑厚度分别为269.47±26.78μm和261.19±17.09μm（p = 0.093）。黄斑下脉络膜厚度分别为295.38±33.70μm和322.16±70.24μm（p = 0.026）；颞侧脉络膜厚度分别为246.77±21.83μm和265.26±52.34μm（p = 0.034）；鼻侧脉络膜厚度分别为135.36±28.10μm和158.88±49.16μm（p = 0.008）。以黄斑为中心的1.5mm区域的总CA分别为0.49±0.08mm和0.55±0.09mm（p = 0.002）；以黄斑为中心的1.5mm区域的总CVI分别为63.66%±1.23和64.90%±1.07（p < 0.001）；以黄斑为中心的6mm区域的总CA分别为1.61±0.22mm和1.80±0.33mm（p = 0.003）；以黄斑为中心的6mm区域的总CVI分别为63.85%±1.16和64.87%±1.12（p < 0.001）。mRss评分与雷诺现象严重程度以及CMT、CVI和CTs之间无相关性；然而，mRss与雷诺现象严重程度之间存在正相关（p = 0.0004，r = 0.507）。
本研究发现SSc患者的脉络膜厚度和CVI降低。CVI降低可能是损伤的一个指标，尤其是在管腔结构中。
