Ab0880 correlation Between the Results of Nail Fold Capillaroscopy and Optical Coherence Tomography Angiography in Patients With Systemic Sclerosis

Abstract

BackgroundVasculopathy of blood vessels are, apart from immunological disorders, an important.common pathogenetic link of dangerous organ complications in systemic sclerosis (SSc).Endothelial damage is one of the mechanisms leading to disorders of vascular hemostasis, platelet activation, thrombosis causing coagulopathy and microangiopathy.Nailfold capillaroscopy (NC) is a non-invasive diagnostic tool for the detection and monitoring patients with SSc and current methods of the assessment of microcirculation and capillary structure within the nail folds.Although vascular pathologies can occur in other organs including the organ of vision. Optical coherence tomography angiography (OCT A) is a noninvasive imaging method of microvasculature of the retina and choroid providing the assessment of retinal perfusion.Objectives: The aim of the study was to evaluate the correlation between the optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) parameters and capillaroscopic results.ObjectivesThe aim of the study was to evaluate the correlation between the optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) parameters and capillaroscopic results.Methods31 patients (pts) with SSc diagnosed were included to the study. Mean age of the patients was 35,1 (8,3). Capillaroscopy was performed. The modified Rodnan Skin Score (mRSS) examination was taken by one assessor at the time of the study. There were measured HRCT, proBNP. echocardiography. Finger ulcers were observed in physical examination. OCTA scans were collected from 31 patients. 61 eyes were included to the study to assess changes in retinal microcirculation. Foveal avascular zone (FAZ) in superficial plexus and deep plexus, parafoveal mean superficial vessel density and parafoveal mean deep vessel density were correlated to NF findings and other parameters used in rheumatic examination.All the statistical procedures were performed by using STATGRAPHICS Centurion, version 19.4 (Statgraphics Technologies, Inc., The Plains, Virginia, USA).ResultsIn our study group 74 % has diffuse Scc, 26% has limited SSc. InNC: 5 pts has early pattern, 12 has active pattern,9 pts has late pattern. Only one person has pulmonary arterial hypertension (PAH) and 8 pts have active finger ulcers.Interstitial lung disease was observed in 12 pts. (67% has non-specific interstitial pneumonia (NSIP) and 33% usual interstitial pneumonia (UIP)). Elevated proBNP were detect in 17,8%The parafoveal mean superficial vessel density correlated positively and statistically significantly with mRSS (p=0,0460). Patients with early scleroderma pattern in capillaroscopy showed larger superficial FAZ (0,4± 0,07 mm2) than pts with active (0,24 ± 0,09 mm2)and late (0,22 ±0,09 mm2). There was correlation between deep FAZ area and scleroderma pattern showing larger FAZ in pts with active (0,46±0,14 mm2) than pts with active (0,2 ±0,12 mm2) and late (0,17±0,13 mm2). Statistically significant difference was found between interstitial lung disease NSIP and UIP in correlation with deep FAZ area. Pts with NSIP had larger FAZ (0,32 ±0,14 mm2) than UIP pts (0,17 ±0,12 mm2). Moreover, NSIP pts had higher parafoveal mean superficial vessel density (42,21% ±1,69) than UIP (39,89 ±1,23). NSIP pts had also higher mean parafoveal deep vessel density (43,58 ±1,5 %) than UIP pts (41,72 ±1,55 %).ConclusionIn conclusion, our findings indicate ocular vascular abnormalities in patient with SSc. The results show the important role of OCTA in diagnosis, monitoring and prognosis of microvascular changes in SSc. Moreover, NF correlate with FAZ.Reference[1]Rommel F, Prangel D, Prasuhn M, Grisanti S, Ranjbar M. Correlation of retinal and choroidal microvascular impairment in systemic sclerosis. Orphanet J Rare Dis. 2021 Jan 13;16(1):27. doi: 10.1186/s13023-020-01649-5Figure 1.OCTA image of foveal avascular zone area in the right eye of the patient with systemic sclerosis.Acknowledgements:NIL.Disclosure of InterestsNone Declared.