Retinal vessel morphology in rheumatoid arthritis: Association with systemic inflammation, subclinical atherosclerosis, and cardiovascular risk

Abstract

Our study shows altered retinal microvascular morphology in RA patients. Inflammation appears as the biological link for the observed association between retinal microvascular abnormalities and subclinical atherosclerosis. Retinal arteriolar narrowing might play its own role in cardiovascular risk prediction in RA.

Urinary albumin excretion in rheumatoid arthritis is not associated with markers of vasculopathy in distal microvascular beds

“…We included subtle markers indicative of microvascular injury in the coronary artery network, in the retinal microvasculature, and the dermal capillary network, which have been previously shown to be impaired in patients with RA, even in the absence of overt cardiovascular disease. [11][12][13] By contrast, neither UAE nor the prevalence of microalbuminuria differed in the present cohort of RA patients, compared to the control group (Table 1). Moreover, no significant associations were observed between UAE and any of the included microvascular indices denoting morphological alterations in the retinal microvasculature, impaired myocardial perfusion, and dermal capillary rarefaction.…”

“…In the present study, we studied for the first time the association of UAE with markers of microvascular injury in distal microvascular beds, in a population of RA patients. We included subtle markers indicative of microvascular injury in the coronary artery network, in the retinal microvasculature, and the dermal capillary network, which have been previously shown to be impaired in patients with RA, even in the absence of overt cardiovascular disease . By contrast, neither UAE nor the prevalence of microalbuminuria differed in the present cohort of RA patients, compared to the control group (Table ).…”

“…The strengths of this study include the reliable evaluation of UAE with the gold standard 24‐hour urine collection, and the meticulous assessment of distinct microvascular beds, which are important either in terms of functionality (coronary microcirculation) or accessibility (retina, dermal capillary network), using methodology that has been previously applied in RA patients and other populations . An important limitation of our study concerns the relatively small sample size.…”

“…Chronic anti-inflammatory treatment in patients with RA, specifically anti-TNF treatment, might be accompanied by significant renoprotective effects by altering the mechanism thought to underlie albuminuria. 17,35 [11][12][13] and other populations. [25][26][27]30 An important limitation of our study concerns the relatively small sample size.…”

“…9 It is postulated that these proatherogenic effects mediated by RA are not only limited in large conduit arteries with the formation of atheromatous plaques, but may also manifest as a state of generalized microvascular dysfunction that involves the coronary vessels. 10 We have previously shown that RA is associated with diffuse microvascular injury, evidenced by decreased myocardial perfusion, 11 altered retinal microvascular morphology, 12 and pronounced dermal capillary rarefaction, 13 even in the absence of overt cardiovascular disease.…”