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Luisa Pierro, Claudia Del Turco, Francesca Ingegnoli, Elisabetta Miserocchi, Marco Gagliardi, Giulio Modorati, Francesco Bandello; Spectral Domain OCT Choroidal and Macular Thickness Evaluation in Primary and Secondary Raynaud's Phenomenon. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3348.
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Raynaud’s phenomenon (RP) is a disorder characterized by systemic vascular dysregulation which has been related with vasospasms and retinal blood flow abnormalities. Nevertheless among the potential complications of RP, eye involvement is often overlooked. The aim of this study was to evaluate the presence of vascular eye involvement measuring the choroidal and macular thickness in a cross-sectional cohort of RP at the first rheumatologic evaluation.
Thirty adult consecutive RP, without visual symptoms, underwent: clinical evaluation and nailfold capillaroscopy. Patients underwent a complete ocular examination including: best corrected visual acuity; slit lamp biomicroscopy; intraocular pressure measurements and fundus examination; choroidal thickness by Zeiss Cirrus Spectral Domain Optical Coherence Tomography with enhanced depth imaging scan system at the fovea and up to 2mm at intervals of 1mm from the fovea in the superior, inferior, nasal and temporal choroid; central foveal thickness (CFT) was also measured. 27 healthy, sex and age-matched, subjects were analysed as control group. Statistical analysis was performed by one-way ANOVA and multiple comparisons.
Eight primary RP (pRP) (median age 53 yrs), 12 early systemic sclerosis (SSc) (median age 57 yrs), 10 RP secondary to suspected connective tissue disease (CTD) (median age 54 yrs). Fundus examination revealed normal arterial and venous vessels in all patients. The mean best corrected visual acuity was 20/20. In pRP, mean choroidal thickness was significantly thinner than healthy controls in the outer nasal (224.8μm vs 289μm; p<0.05) and outer temporal (263.3μm vs 299μm; p<0.05) regions. In patients with RP secondary to suspected CTD the inner and outer nasal were significantly thinner (244.1μm vs 297.4μm; p<0.05 and 199.7μm vs 289μm; p<0.0001 respectively). In SSc all the areas examined were significantly thinner than healthy controls. CFT was also thinner in all the patients than healthy controls although not significant.
A thinner choroidal and macular thickness was observed in all the patients, with progressive decrease from pRP to SSc. These data suggest an early involvement of ocular microcirculation with significant reduction of choroidal perfusion.
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