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Evaluation of retinal microvascular perfusion in systemic sclerosis: a case–control study
  1. Matthias Rothe1,2,
  2. Felix Rommel1,2,
  3. Sebastian Klapa3,
  4. Jens Y Humrich3,
  5. Relana Nieberding3,
  6. Tanja Lange3,
  7. Jan A M Sochurek2,
  8. Pauline Plöttner2,
  9. Salvatore Grisanti1,
  10. Gabriela Riemekasten3,
  11. Mahdy Ranjbar1,2
  1. 1 Department of Ophthalmology, University of Lübeck, Lübeck, Germany
  2. 2 Laboratory for Angiogenesis and Ocular Cell Transplantation, University of Lübeck, Lübeck, Germany
  3. 3 Department of Rheumatology and Clinical Immunology, University of Lübeck, Lübeck, Germany
  1. Correspondence to Dr Mahdy Ranjbar, Department of Ophthalmology, University of Lübeck, Lübeck 23538, Germany; eye.research101{at}

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Systemic sclerosis (SSc) is a multisystem connective tissue disease characterised by obliterative vasculopathy that is not limited to the peripheral microcirculation of the skin, but is also observed in other organs.1 Retinal vascular disease in SSc indicating endothelial cell damage has a prevalence of 34%–55% and might be apparent long before patients become symptomatic.2 3 The gold standard to evaluate retinal microvascular alterations has been fluorescence angiography (FA) for the last 60 years.4 However, the use of FA is quite laborious because it is an invasive procedure that takes time and needs an experienced ophthalmologist to review the resulting images carefully. Recently, optical coherence tomography angiography (OCTA) has been introduced, which generates angiographic images based on motion contrast imaging to high-resolution volumetric blood flow information in a few seconds.5 OCTA is a non-invasive technique, which allows the quantification of perfused and non-perfused areas of the retina in primarily ocular pathologies, but it also mirrors vascular involvement in systemic diseases as most recently shown for systemic lupus erythematosus.6 The aim of this study was to evaluate …

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  • MR and FR are joint first authors.

  • MR and FR contributed equally.

  • Handling editor Josef S Smolen

  • Correction notice This article has been corrected since it published Online First. The footnotes in table 1 have been corrected.

  • Contributors MR and FR coordinated the ophthalmological examinations and data analysis. SK and JYH coordinated the rheumatological examinations and reviewed data analysis as well as revised the manuscript. RN contributed to the clinical data. TL contributed to the clinical data and revised the manuscript. JAMS and PP contributed to the collection of OCTA data. SG revised the manuscript. GR reviewed data analysis as well as revised the manuscript. MRa designed and coordinated the study, reviewed the data and wrote the manuscript.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Ethics approval Institutional review board at the University of Lübeck (vote reference number 17–008).

  • Provenance and peer review Not commissioned; externally peer reviewed.