Prevalence of retinal changes in patients with systemic sclerosis: the association between retinal vascular changes and nailfold capillaroscopic findings

• Published in: Reumatologia 2021-01, Vol.59 (1), p.27-34
• Main Authors: Shenavandeh, Saeedeh, Afarid, Mehrdad, Hasanaghaei, Tarlaan, Nazarinia, Mohammad Ali
• Format: Article
• Language: English
• Subjects: Blood vessels; capillaroscopy; Connective tissue diseases; Hemorrhage; nailfold capillaroscopy; Original Paper; Photography; Retina; retinal tortuosity; Scleroderma; Skin diseases; Systemic sclerosis
• ISSN: 0034-6233; 2084-9834
• DOI: 10.5114/reum.2021.103436

Systemic sclerosis (SSc) is a connective tissue disease affecting the skin and multiple organs. Most of the evidence on ocular involvement comes from small studies. We evaluated the retinal vascular changes in patients with SSc and its associations with types, disease duration, skin score, and nailfold capillaroscopy changes. We evaluated the demographic, clinical and nailfold capillaroscopy data of 52 patients referring to the clinic of scleroderma with SSc according to the 2013 ACR/EULAR SSc criteria. In addition, full ophthalmic examination in 52 patients and fundus photography in 40 patients were done in the ophthalmology clinic. There were 52 (49 women and 3 men, 17 diffuse and 35 limited) patients with SSc with mean disease duration of 8 ±5 years and mean age of 40 ±9 years. Retinal changes in the ophthalmologic examination were seen in 30.7% as increased vascular tortuosity. None of the patients had cotton wool spot, hemorrhage or hard exudate. Forty patients underwent fundus photography and 22.5% of them had vascular tortuosity. Only the presence of hemorrhage in the nailfolds was correlated with retinal tortuosity, and the other characteristics of nailfold capillaroscopy did not have any association with retinal changes. Retinal vascular changes were seen in about one third of our patients. There was no correlation between nailfold capillaroscopy, disease duration, type and skin score of SSc patients and retinal vascular changes. These findings suggest that the mechanisms or the quality of changes in the retinal vessels and nailfold vasculature may be different.