Original Article

J Rheum Dis 2013; 20(4): 231-237

Published online August 30, 2013

© Korean College of Rheumatology

류마티스관절염 환자에서 형광 안저 촬영을 이용한 미세혈관 변화의 관찰

여현정ㆍ이지현ㆍ이홍직ㆍ변기섭ㆍ임호준ㆍ김민정

메리놀병원 류마티스내과

Microvascular Findings in Patients with Rheumatoid Arthritis - Assessed, Using Fundus Photography and Fluorescein Angiography

Hyun Jung Yeo, Ji Hyun Lee, Hong Jik Lee, Ki Sup Byun, Ho Joon Im, Min Jung Kim

Division of Rheumatology, Department of Internal Medicine, Maryknoll Medical Center, Busan, Korea

Correspondence to : Ji Hyun Lee

Abstract

Objective. Although a series of trials support that rheuma-toid arthritis (RA) is associated with increased athero-sclerosis, the link between microvascular structural changes and the disease activity of RA has not been clarified. We measured changes in the retinal micro-vasculature using fundus fluorescein angiography (FAG) and investigated the association between the retinal vascu-lature and clinical parameters of RA.
Methods. Seventy-five RA patients and sixty healthy con-trol were included. Morphometric and quantitative fea-tures in the capillary images including retinal vascular signs and vessel diameters were measured with fundus photography and FAG. RA activity was assessed based on high sensitivity C-reactive protein (hsCRP), disease activ-ity score with 28 joints (DAS 28), and health assessment questionnaire (HAQ).
Results. Central retinal arteriolar equivalents (CRAE) was 118.1±31.3 Ռm in RA patients and 123.8±19.9 Ռm in con-trol subjects, showing the tendency of retinal arteriolar nar-rowing in patients with RA but without statistical significance. The mean central retinal venular equivalents (CRVE) was 162.4±26.4 Ռm which was significantly higher than that of control group (144.1±23.1 Ռm, p<0.001). The prevalence of AVN was 34.7%, and significantly higher in RA group. Among retinal findings, the presence of early pinpoint hyperfluorescence and areas of delayed choroidal perfusion correlated with hsCRP. Age, disease duration, DAS 28, HAQ, and rheumatoid factor (RF) had no effect on CRAE and CRVE. In multivariate analysis, only hsCRP was found to be associated with wider venular caliber.
Conclusion. Retinal venular widening was more common in RA patients. Retinal venular diameter had significant correlation with disease activity of RA. Retinal imaging is a comparative method for the assessment of microvascular findings of RA patients.

Keywords Rheumatoid arthritis, Fundus photography, Central retinal arteriolar equivalents, Central retinal ven-ular equivalents

Article

Original Article

J Rheum Dis 2013; 20(4): 231-237

Published online August 30, 2013

Copyright © Korean College of Rheumatology.

류마티스관절염 환자에서 형광 안저 촬영을 이용한 미세혈관 변화의 관찰

여현정ㆍ이지현ㆍ이홍직ㆍ변기섭ㆍ임호준ㆍ김민정

메리놀병원 류마티스내과

Microvascular Findings in Patients with Rheumatoid Arthritis - Assessed, Using Fundus Photography and Fluorescein Angiography

Hyun Jung Yeo, Ji Hyun Lee, Hong Jik Lee, Ki Sup Byun, Ho Joon Im, Min Jung Kim

Division of Rheumatology, Department of Internal Medicine, Maryknoll Medical Center, Busan, Korea

Correspondence to:Ji Hyun Lee

Abstract

Objective. Although a series of trials support that rheuma-toid arthritis (RA) is associated with increased athero-sclerosis, the link between microvascular structural changes and the disease activity of RA has not been clarified. We measured changes in the retinal micro-vasculature using fundus fluorescein angiography (FAG) and investigated the association between the retinal vascu-lature and clinical parameters of RA.
Methods. Seventy-five RA patients and sixty healthy con-trol were included. Morphometric and quantitative fea-tures in the capillary images including retinal vascular signs and vessel diameters were measured with fundus photography and FAG. RA activity was assessed based on high sensitivity C-reactive protein (hsCRP), disease activ-ity score with 28 joints (DAS 28), and health assessment questionnaire (HAQ).
Results. Central retinal arteriolar equivalents (CRAE) was 118.1±31.3 Ռm in RA patients and 123.8±19.9 Ռm in con-trol subjects, showing the tendency of retinal arteriolar nar-rowing in patients with RA but without statistical significance. The mean central retinal venular equivalents (CRVE) was 162.4±26.4 Ռm which was significantly higher than that of control group (144.1±23.1 Ռm, p<0.001). The prevalence of AVN was 34.7%, and significantly higher in RA group. Among retinal findings, the presence of early pinpoint hyperfluorescence and areas of delayed choroidal perfusion correlated with hsCRP. Age, disease duration, DAS 28, HAQ, and rheumatoid factor (RF) had no effect on CRAE and CRVE. In multivariate analysis, only hsCRP was found to be associated with wider venular caliber.
Conclusion. Retinal venular widening was more common in RA patients. Retinal venular diameter had significant correlation with disease activity of RA. Retinal imaging is a comparative method for the assessment of microvascular findings of RA patients.

Keywords: Rheumatoid arthritis, Fundus photography, Central retinal arteriolar equivalents, Central retinal ven-ular equivalents

JRD
Jan 01, 2025 Vol.32 No.1, pp. 1~7
COVER PICTURE
Cumulative growth of rheumatology members and specialists (1980~2024). Cumulative distribution of the number of the (A) Korean College of Rheumatology members and (B) rheumatology specialists. (J Rheum Dis 2025;32:63-65)

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