EVALUATION OF RETINAL MICROCIRCULATION IN PATIENTS WITH SCLERODERMA

Objective: Scleroderma is an autoimmune disease characterized by collagen deposition and microcirculation abnormalities. Multiorgan involvement in scleroderma has been extensively studied, but little is known about microcirculation involvement. For these reasons we aimed to evaluate the structure of retinal arterioles using Adaptive Optics in patients with scleroderma presenting different forms of organ involvement and already undergoing prostaglandin treatment. Design and method: Seventy-two scleroderma patients (mean age 63 ± 11 years, 68 F) attending the Rheumatology division outpatient clinics of the ASST Spedali Civili in Brescia underwent an evaluation of the retinal microcirculation through Adaptive Optics retinal camera in order to assess the wall-to-lumen ratio (WLR) and the wall cross-sectional area (WCSA) of the retinal arterioles. Results: A significant correlation was found between WLR and age and systolic blood pressure (r=0,43, p<0.001 and r=0,34, p=0,019 respectively). No significant differences in organ involvement, antibody type, or disease duration were observed. Additionally, no significant correlations were found with smoking habits, arterial hypertension, dyslipidemia, or diabetes mellitus. An inverse correlation was also observed between WLR and creatinine clearance (r=-0,25, p=0,044). Conclusions: In scleroderma patients microcirculation alterations could contribute to increase the cardiovascular risk of these patients. The renal involvement in scleroderma disease may be associated with alterations in the structure of the retinal microcirculation.