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KMID : 0388220130200040231
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Journal of the Korean Rheumatism Association
2013 Volume.20 No. 4 p.231 ~ p.237
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Microvascular Findings in Patients with Rheumatoid Arthritis - Assessed, Using Fundus Photography and Fluorescein Angiography
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Yeo Hyun-Jung
Lee Ji-Hyun
Lee Hong-Jik
Byun Gi-Sup
Im Ho-Joon
Kim Min-Jeong
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Abstract
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Objective. Although a series of trials support that rheuma-toid arthritis (RA) is associated with increased athero-sclerosis, the link between microvascular structural changes and the disease activity of RA has not been clarified. We measured changes in the retinal micro-vasculature using fundus fluorescein angiography (FAG) and investigated the association between the retinal vascu-lature and clinical parameters of RA. Methods. Seventy-five RA patients and sixty healthy con-trol were included. Morphometric and quantitative fea-tures in the capillary images including retinal vascular signs and vessel diameters were measured with fundus photography and FAG. RA activity was assessed based on high sensitivity C-reactive protein (hsCRP), disease activ-ity score with 28 joints (DAS 28), and health assessment questionnaire (HAQ). Results. Central retinal arteriolar equivalents (CRAE) was 118.1±31.3 ?m in RA patients and 123.8±19.9 ?m in con-trol subjects, showing the tendency of retinal arteriolar nar-rowing in patients with RA but without statistical significance. The mean central retinal venular equivalents (CRVE) was 162.4±26.4 ?m which was significantly higher than that of control group (144.1±23.1 ?m, p＜0.001). The prevalence of AVN was 34.7%, and significantly higher in RA group. Among retinal findings, the presence of early pinpoint hyperfluorescence and areas of delayed choroidal perfusion correlated with hsCRP. Age, disease duration, DAS 28, HAQ, and rheumatoid factor (RF) had no effect on CRAE and CRVE. In multivariate analysis, only hsCRP was found to be associated with wider venular caliber. Conclusion. Retinal venular widening was more common in RA patients. Retinal venular diameter had significant correlation with disease activity of RA. Retinal imaging is a comparative method for the assessment of microvascular findings of RA patients.
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KEYWORD
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Rheumatoid arthritis, Fundus photography, Central retinal arteriolar equivalents, Central retinal ven-ular equivalents
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