Background Systemic sclerosis (SSc) is a connective tissue disease characterized by progressive microvascular involvement (1). Nailfold videocapillaroscopy (NVC) represents the best and safest method to detect and to follow the progression of morphological microvascular SSc abnormalities (2). Microvascular alterations in SSc are observed in several organs, including the choroidal plexus of the eye (3). Modern optical coherence tomography (OCT) imaging and analysis have allowed the choroid to become observable and measurable (4). An overall thinning of choroidal layer has been observed in SSc patients consistent with an impairment of choroidal perfusion; the process becomes progressively more severe and extensive in overt SSc (5).
Objectives To compare severity of nailfold microvascular damage with the choroidal thickness, as assessed by NVC and OCT. To evaluate OCT plausibility in SSc staging.
Methods Twelve SSc patients according to recent ACR/EULAR classification criteria (6) (disease duration 4.8 ± 2.8 years, age 58±13 years) underwent NVC (4 “early”, 3 “active”, 5 “late” scleroderma NVC pattern) and ophthalmologic examination by OCT. NVC patterns were scored by quantitative rating scale and the “microangiopathy evolution score (MES)” was calculated (7). OCT images were recorded by 3D-2000 OCT using protocol “line” that averages 50 B-scans and generates a horizontal 6 mm line. Choroidal thickness area measurements were performed manually using image J software. Statistical analysis was performed by non parametric tests.
Results Despite the limited number of enrolled SSc patients, a statistically significant negative correlation was observed between the progressive severity of the microvascular damage score (MES) and the choroidal thickness values (OCT) (r=-0.39, p=0.05).
Conclusions Nailfold microangiopathy evolution, as evaluated by NVC in SSc patients, seems to correlate with the choroid thickness, as assessed by OCT. Microangiopathy progression seems to involve the choroidal plexus by showing a thinner layer thickness in SSc patients. Therefore, OCT may be useful in the evaluation of possible retinal microvascularization damage in SSc patients.
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Disclosure of Interest None declared