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Analysis of Retinal and Choroidal Microvasculature in Systemic Sclerosis Using Optical Coherence Tomography Angiography: A Systematic Review and Meta-Analysis Publisher Pubmed



Lohrasbi F1 ; Karimi E2 ; Gouravani M2 ; Sarabi SF3 ; Mafi A4 ; Beikmarzehei A4 ; Sanjari Moghaddam H2 ; Parsaei M5 ; Tabatabaei SM4 ; Fernando Arevalo JF6
Authors
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Authors Affiliations
  1. 1. School of Medicine, Babol University of Medical Sciences, Babol, Iran
  2. 2. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Ardabil University of Medical Sciences, Ardabil, Iran
  4. 4. Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Maternal Fetal and Neonatal Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, United States

Source: Ophthalmic Research Published:2024


Abstract

Introduction: Optical coherence tomography angiography (OCTA) is an emerging technique to investigate retinal and choroidal microvascular alterations in patients with systemic sclerosis (SSc). This systematic review and metaanalysis aimed to evaluate the features of retinal and choroidal microvasculature using OCTA among SSc patients. Methods: The methodology of the study was based on PRISMA guidelines. PubMed, Scopus, Web of Science, and Embase were searched systematically on November 25, 2023, for relevant studies utilizing OCTA as the main diagnostic tool to assess the retinal and choroidal microvasculature in SSc patients versus healthy controls. Random-effect or fixed model meta-analysis was used based on the heterogeneity of studies. Results: Eleven observational comparative studies, including 366 patients with SSc and 350 healthy controls, conducted between 2020 and 2023, were included in this review. Meta-analysis findings revealed a significant decrease in vessel densities in both the superficial and deep capillary plexuses among SSc patients compared to controls. However, there were no significant differences observed in the foveal avascular zone area and choriocapillaris flow area between SSc patients and controls. Moreover, central macular thickness (CMT) consistently exhibited a decrease in SSc patients, while retinal nerve fiber layer thickness showed no significant differences. Although radial peripapillary capillary vessel density, subfoveal choroidal thickness, and cup/disk ratio yielded mixed results, with some studies indicating significant changes in the SSc group, meta-analysis could not be performed due to variations in the OCTA machines used across the included studies. Conclusion: This systematic review demonstrates retinal and choroidal microvascular abnormalities in SSc using OCTA. Longitudinal studies are needed to understand how these abnormalities evolve over time in patients with SSc and whether these abnormalities correlate with the clinical features of SSc. © 2024 The Author(s).