Multimodal Evaluation of patients with Primary Antiphospholipid Syndrome Using Optical Coherence Angiotomography and Microperimetry

Abstract

Purpose : To perform a multimodal evaluation, including the use of optical coherence angiography (OCTA), in patients with primary antiphospholipid syndrome without eye symptoms.

Methods : Patients diagnosed with Primary Antiphospholipid Syndrome (APS), the most common acquired autoimmune thrombophilia, and followed up at the Rheumatology Clinical Division of the University of São Paulo School of Medicine were included. The selected patients undergone best corrected visual acuity (BCVA) assessment, biomicroscopic and fundus examination, tonometry, axial length measurement with the IOL MASTER 500 (Carl Zeiss Meditec Inc, Dublin, CA), structural and angiographic optical coherence tomography (OCT) (HeidelbergSpectralis, Carlsbad, USA), and microperimetry (Nidek MP3, Japan).

Results : 50 eyes from 25 patients (21 female and 4 male) were analyzed. Patient’s median age was 45.84 years old (range 24-71). All patients had BCVA of 20/20 on both eyes. While biomicroscopy and fundus examination were normal, multimodal exams revealed retinal changes in 20% of the eyes. In those cases, a localized inner retinal thinning was observed at structural OCT, and confirmed by OCTA as well as corresponding localized microperimetry defects.

Conclusions : A high frequency of patients with primary APS have undiagnosed asymptomatic retinal changes with microperimetric-related defects, that can be observed on multimodal analysis. The role of those findings as a marker of disease severity or progression may warrant future investigation.

This is a 2020 ARVO Annual Meeting abstract.