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Optical coherence tomography angiography findings in axial spondylarthritis

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Abstract

The aim of this study is to evaluate the density of retinal vascular structures and their relationship with disease duration and activity in patients with axial spondylarthritis (axSpA) using optical coherence tomography angiography (OCT-A). In this case–control study, 56 eyes of 29 axSpA patients and 61 eyes of 31 healthy controls (HCs) were evaluated using OCT-A. The capillary plexus density (CPD) of vessels in the parafovea and perifovea regions was evaluated from the superficial capillary plexus (SCP) and deep capillary plexus (DPC) flow areas. The CPD of vessels in the fundus was evaluated from the radial peripapillary capillary (RPC) flow area. Foveal avascular zone (FAZ) size was measured. In axSpA patients and HCs, the mean CPD (%) in the whole retina was 50.75 ± 2.59 and 52.43 ± 2.10 (p < 0.001) in SCP, 54.00 ± 5.83 and 58.37 ± 4.36 (p < 0.001) in DCP, and 50.13 ± 2.32 and 50.13 ± 2.26 (p = 0.984) in RPC flow areas, respectively, and the mean FAZ (mm) was 0.275 ± 0.10 and 0.294 ± 0.07 (p = 0.281), respectively. A significant negative correlation was detected between the CPD and disease duration in the parafovea (ρ: − 0.306, p = 0.022), parafovea superior-hemi (ρ = − 0299, p = 0.025), parafovea inferior-hemi (ρ = − 0.270, p = 0.044), parafovea temporal (ρ = − 0.349, p = 0.008) and parafovea nasal regions (ρ = − 0.356, p = 0.007) in the DCP flow area. CPD was found to be lower in the macula, while similar in the fundus region in axSpA patients compared to HCs. The decrease in CPD was correlated with disease duration, but not with disease activity in axSpA. Small vessel structures may be affected in axSpA. OCT-A may be used to detect subclinical vasculitis in axSpA patients.

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Acknowledgements

We would like to thank Yasemin Çalışkan, M.D. and Cem Kaya, M.D. for their help in collecting the data.

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Authors and Affiliations

  1. Department of Internal Medicine, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey

    Nizameddin Koca

  2. Department of Internal Medicine, Division of Rheumatology, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey

    Koray Ayar

  3. Department of Ophthalmology, Bursa Sehir Training and Research Hospital, Bursa, Turkey

    Mehmet Erol Can

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  1. Nizameddin Koca
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Correspondence to Koray Ayar.

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The local ethics committee approval (2011-KAEK-25 2018/11-05) was obtained and the study was carried out in accordance with the declaration of Helsinki. A written informed consent was obtained from all participants.

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Koca, N., Ayar, K. & Can, M.E. Optical coherence tomography angiography findings in axial spondylarthritis. Rheumatol Int 40, 901–913 (2020). https://doi.org/10.1007/s00296-020-04553-0

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