PP.19.28] DETECTION OF RETINAL MICROVASCULAR ALTERATIONS IN RHEUMATOID ARTHRITIS PATIENTS WITHOUT CARDIOVASCULAR DISEASES

Abstract

Objective: Quantitative evaluation of the retinal vasculature using the non-mydriatic fundus camera is gaining increasing attention as an early, subclinical indicator of cardiovascular risk. Subtle alterations of the retinal vessels have been consistently observed in populations with cardiovascular diseases. However, it has not been investigated whether the retinal microvasculature is affected in patients with autoimmune rheumatic diseases, who are typically perceived as a high-cardiovascular risk population, in the absence of established cardiovascular disease. Design and method: Consecutive patients with rheumatoid arthritis were recruited from the Rheumatology Outpatient Unit of our Department and were matched with healthy, nontreated volunteers for the purposes of the study. Patients were free from cardiovascular comorbidities including high blood pressure, diabetes mellitus, heart diseases and stroke. All participants underwent fundus photography with a non mydriatic NIDEK AFC-230/210 camera. Semi-automated software was developed to calculate central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE), as well as the retinal arteriovenus ratio (AVR). Results: A total of 28 patients with rheumatoid arthritis and 32 controls aged 57.1 ± 10.9 years were included in the study. Patients were matched with controls in terms of age, gender, systolic/diastolic blood pressure and cholesterol levels (p > 0.05 for all). Patients exhibited significantly lower CRAE compared to controls (81.1 ± 11.0 vs 92.9 ± 8.3, p < 0.001), and the same was observed with AVR (0.70 ± 0.09 vs 0.83 ± 0.08, p < 0.001). CRVE was comparable between patients and controls (117.2 ± 15.4 vs 112.7 ± 11.2, p = 0.204). Conclusions: Narrower retinal arteriolar calibre and lower AVR were observed in a meticulously selected sample of rheumatoid arthritis patients without established cardiovascular diseases. Rheumatoid arthritis patients may exhibit subtle retinal microvascular abnormalities, even in the absence of clinically evident cardiovascular disease.