Retinal microvascular and microstructural alterations in the diagnosis of dermatomyositis: a new approach

Bo-Zhi Huang; Qian Ling; San-Hua Xu; Jie Zou; Miao-Miao Zang; Xu-Lin Liao; Hong Wei; Ping Ying; Chong-Gang Pei; Yi Shao

doi:10.3389/fmed.2023.1164351

Retinal microvascular and microstructural alterations in the diagnosis of dermatomyositis: a new approach

Front Med (Lausanne). 2023 May 25:10:1164351. doi: 10.3389/fmed.2023.1164351. eCollection 2023.

Authors

Bo-Zhi Huang¹, Qian Ling¹, San-Hua Xu¹, Jie Zou¹, Miao-Miao Zang¹, Xu-Lin Liao², Hong Wei¹, Ping Ying¹, Chong-Gang Pei^#¹, Yi Shao^#¹

Affiliations

¹ Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
² Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.

^# Contributed equally.

Abstract

Purpose: To study the relationship between fundus alterations, including retinal thickness and microvascular changes, and dermatomyositis (DM) using optical coherence tomography angiography (OCTA).

Methods: A total of 16 patients with DM (32 eyes) and 16 healthy controls (HCs; 32 eyes) participated in this study. Based on the Early Treatment Diabetic Retinopathy Study subzones, OCTA fundus data were divided into different layers and regions for comparison.

Results: The full retinal thickness (RT) in the inner nasal (IN), outer nasal (ON), inner inferior (II), and outer inferior (OI) regions of patients with DM was significantly lower than that of HCs (P < 0.001). The inner layer RT was also significantly lower in the IN, ON, II, and OI regions in patients with DM (P < 0.001). The outer layer RT was lower only in the II region in patients with DM compared to HCs (P < 0.001). The full RT of the II region was more sensitive to the pathological changes of disease since its ROC curve had an AUC of 0.9028, 95% CI: 0.8159-0.9898. Meanwhile, the superficial vessel density (SVD) of patients with DM was significantly lower in the IN, ON, II, and OI regions compared to HCs (P < 0.001). The AUC for region II was 0.9634 (95% CI: 0.9034-1.0), which indicated good diagnostic sensitivity.

Conclusion: Optical coherence tomography angiography can be used to evaluate relevant ocular lesions and monitor disease progression in patients with DM and interstitial lung disease.

Keywords: dermatomyositis (DM); interstitial lung disease; optical coherence tomography angiography; retinal thickness; vessel density.

Grants and funding

This study was supported by the National Natural Science Foundation (No. 82160195), Key Research Foundation of Jiangxi Province (Nos. 20202BBG73030 and 20203BBG73059), and Natural Science Foundation of Jiangxi Province (Nos. 20192BAB205046 and 20202BABL206078).