Ocular involvement in primary antiphospholipid syndrome: results of an extensive ophthalmological evaluation performed in the APS-Rio cohort.

Autor: Franco AMM; Ophthalmology Division, Hospital Universitário Pedro Ernesto (HUPE), 28130Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil., Makita LS; Ophthalmology Division, Hospital Universitário Pedro Ernesto (HUPE), 28130Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil., Perrut VC; Ophthalmology Division, Hospital Universitário Pedro Ernesto (HUPE), 28130Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil., Balbi GGM; Rheumatology Division, Hospital Universitário, 28113Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, Brazil., Barros AM; Ophthalmology Division, Hospital Universitário Pedro Ernesto (HUPE), 28130Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil., Medina FMC; Ophthalmology Division, Hospital Universitário Pedro Ernesto (HUPE), 28130Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil., Signorelli F; Rheumatology Division, Hospital Universitário Pedro Ernesto (HUPE), 28130Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil.
Jazyk: angličtina
Zdroj: Lupus [Lupus] 2023 Feb; Vol. 32 (2), pp. 180-188. Date of Electronic Publication: 2022 Nov 29.
DOI: 10.1177/09612033221143294
Abstrakt: Objective: To study ophthalmological manifestations in a well-characterized primary antiphospholipid syndrome (PAPS) cohort (APS-Rio) and compare them with a healthy control group.
Methods: We examined PAPS patients and controls with an extensive ophthalmological evaluation, which included anamnesis, visual acuity, slit-lamp biomicroscopy, binocular indirect ophthalmoscopy, and retinography of the anterior and posterior segments of the eye. PAPS group also underwent angiography exam and optical coherence tomography using spectral domain technology (SD-OCT).
Results: 98 PAPS patients and 102 controls were included. The most common symptom in PAPS was amaurosis fugax (34.7% vs. 6.9%; p = .001). In the multivariate analyses, Raynaud's phenomenon was associated with amaurosis fugax (OR 3.71, CI:1.33-10.32; p = .012), and livedo correlated with hemianopia (OR 6.96, CI:1.11-43.72, p = .038) and diplopia (OR 3.49, CI:1.02-11.53, p = .047). After ophthalmological evaluation, 84 PAPS patients had ocular involvement (1.0% glaucoma, 94.0% posterior findings, 62.7% anterior findings, and 56.6% both posterior and anterior findings). Vascular tortuosity was more frequent in the PAPS group (63.2% vs. 42.2%; p = .002), as well as peripheral tortuosity (29.6% vs. 7.8%; p < .001). After excluding patients with atherosclerotic risk factors, peripheral vascular tortuosity was still statistically associated with PAPS (35.0 vs. 7.8%, p < .001). Triple positivity was more frequent in PAPS patients with peripheral vascular tortuosity than in those without this ocular finding (34.5% vs. 15.9%, p = .041).
Conclusion: Vasomotor phenomena are importantly related to ocular symptoms in PAPS. Vascular tortuosity was a frequent finding in PAPS patients. Peripheral vascular tortuosity was associated with triple positivity and might be a biomarker of ischemic microvascular retinopathy due to PAPS.
Databáze: MEDLINE
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