Optical Coherence Tomography Angiography (OCTA) Metrics in a large cohort with primary Sjögren’s syndrome

Abstract

Purpose : Patients with pSS have an increased risk of subclinical atherosclerosis compared to healthy population. This study aims to investigate the macular microvasculature and explore the OCTA (OCT Angiography) metrics as potential retinal biomarkers in a large cohort of patients with primary Sjögren’s syndrome (pSS).

Methods : A prospective study of 100 eyes of 50 pSS patients who fulfilled the current ACR/EULAR criteria and have been symptomatic for at least 5 years compared to 80 eyes of 40 healthy, age-matched controls. All participants underwent 2.9 mm × 2.9 mm imaging of the macula using the OCTA (Heidelberg Spectralis II, Heidelberg, Germany). The outcome variables were Vessel Area Density (VAD) in circular sectors (c1, c2, and c3) and Foveal Avascular Zone (FAZ). Both variables were measured in three layers: superficial (SVP), intermediate (ICP) and deep capillary Plexus (DCP). All scans were analyzed with the EA-Tool (coded in MATLAB, The MathWorks Inc, and R2017b).

Results : VAD was significantly lower in the innermost circle of DCP c1 in the pSS group compared to healthy controls (29.14± 7.07 vs. 31.78± 9.55, p=0.03). FAZ was larger in both SVP (0.41± 0.13 vs.0.34± 0.11, p< 0.001; Cohens |d| = 0.55) and DCP (0.45± 0.15 vs. 0.4± 0.14, p=0.01; Cohens |d| = 0.38) in pSS group compared to healthy controls.

Conclusions : Our findings indicate microvascular changes in the deep capillary layers of pSS patients, showing reduced vessel area density and enlarged FAZ. This could be due to inflammatory or arteriosclerotic etiology. OCTA could be beneficial as retinal biomarker for vascular risk stratification in pSS. Further longitudinal studies need to be considered in future for validation and implementation of the OCTA in the course of pSS.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.