Retinal Microvasculature in Systemic Sclerosis Patients and the Correlation between Nailfold Capillaroscopic Findings and Optical Coherence Angiography Results.

Background: The comparison of retinal perfusion in the eyes of patients with systemic sclerosis (SSc) and in healthy controls using optical coherence tomography angiography (OCTA). The correlation between nailfold capillaroscopy results and OCTA findings among SSc. Methods: The study enrolled 31 patients with systemic sclerosis and 41 healthy controls. OCTA was performed in both groups to assess the retinal vasculature in the superficial (SCP) and deep (DCP) capillary plexuses and the foveal avascular zone (FAZ) area. Nailfold capillaroscopy (NC) was performed in SSc patients and compared to the FAZ area and the superficial and the deep vessel density. Results: In the SSc group, the parafoveal vessel density in DCP was significantly higher in relation to the mean value (p < 0.0001) and in each quadrant of the macula (p < 0.0001) compared to healthy subjects (p < 0.0001). The patients with early scleroderma patterns in capillaroscopy had a larger superficial and deep FAZ (p = 0.0104, p = 0.0076, respectively) than those with active and late patterns. There was a statistically significant difference in the FAZ when comparing early to active (p < 0.0001) and early to late scleroderma patterns (p < 0.0001). A statistically significant difference was found in the type of interstitial lung disease and the deep FAZ area (p = 0.0484). SSc patients with nonspecific interstitial pneumonia (NSIP) had a larger FAZ than those with usual interstitial pneumonia (UIP) (p = 0.0484). Moreover, NSIP cases had a higher parafoveal mean superficial vessel density than those with UIP (p = 0.0471). Conclusions: Our investigation showed that the peripheral microvascular system correlates with ocular microcirculatory impairment. The results indicate the important role of OCTA in the diagnosis, monitoring, and prognosis of microvascular changes in SSc.

Multimodal Imaging Techniques in Monitoring a Patient with Ocular Decompression Retinopathy.

Ocular decompression retinopathy (ODR) is characterized by multiple retinal hemorrhages. It is a rare complication associated with rapid decrease of intraocular pressure (IOP). The course of ODR is usually asymptomatic and self-limiting, which was confirmed by the observation of our patient. In this study, we present a 5-month follow up of a 77-year-old woman with acute right eye (RE) filtration angle closure who developed symptoms of ODR. Clinical examination and multimodal imaging modalities, including color fundus photography, optical coherence tomography (OCT), OCT angiography (OCTA) and fluorescein angiography (FA), were used to confirm the diagnosis and performed regularly in monitoring the course of the disease. Fundus lesions in the RE included diffuse intraretinal hemorrhages in the posterior pole, which gradually resolved during follow-up time. The fundus of the left eye (LE) was normal. The patient underwent conservative therapy, laser therapy and surgery, achieving stabilization of the IOP and improvement of the local condition in the RE. Of the various multimodal imaging techniques, color fundus photography and OCT seemed to be the most specific and helpful in monitoring the patient with ODR.