Systemic sclerosis: Characterizing candidate retinal and choroidal imaging features using optical coherence tomography

OBJECTIVES: Systemic sclerosis is a complex autoimmune disease characterized by vasculopathy and fibrosis, capable of affecting virtually any organ system, including the eyes. Optical coherence tomography is a non - invasive imaging technique that enables high-resolution cross-sectional visualization of ocular structures. This study aimed to characterize candidate retinal imaging features in systemic sclerosis patients using Optical Coherence Tomography. METHODS: A total of 41 systemic sclerosis patients (10 males, 31 females; mean age: 58.7 ± 11.7 years) and 38 age-matched healthy controls (9 males, 29 females; 61.6 ± 12.8 years) were included. After all participants underwent a comprehensive ophthalmologic assessment, including best-corrected visual acuity, intraocular pressure measurement, slit-lamp biomicroscopy, fundus examination, and optical coherence tomography was applied. RESULTS: The mean best-corrected visual acuity among systemic sclerosis patients was 0.95. The central retinal thickness was slightly reduced in systemic sclerosis patients (241.7 µm) compared to controls (254.9 µm), though the difference was not statistically significant. Subfoveal choroidal thickness showed no significant difference (289.9 µm vs. 285.4 µm in controls). Notably, optical coherence tomography revealed previously unreported fundus abnormalities in systemic sclerosis patients: drusen-like deposits in 19 patients (46.3%), wide-based foveal pit in 26 patients (63%), and epiretinal membrane in 9 patients (21%), all of which occurred significantly more often than in the control group (p < 0.01). CONCLUSION: Systemic sclerosis is associated with a high prevalence of underrecognized retinal findings, like foveal contour abnormalities and drusen-like deposits. While these candidate imaging features require longitudinal validation, they likely reflect the systemic microvascular and fibrotic burden of the disease.