Evaluation of retinal vascularization by optical coherence tomography angiography (OCTA) in rheumatoid arthritis, and its relationship with disease activity.

Purpose: To measure the retinal capillary density quantitatively with optical coherence tomography angiography (OCTA) in patients with rheumatoid arthritis (RA) and healthy controls (HCs), and to evaluate the relationship between OCTA findings and RA disease activity.

Methods: In this cross-sectional study, 106 eyes of RA patients and 71 eyes of HCs were evaluated. RA patients were divided into inactive (DAS28 < 3.2) and active (DAS28 ≥ 3.2) subgroups. Retinal capillary plexus density (CPD) was obtained from the superficial capillary plexus (SCP), deep capillary plexus (DCP), and radial peripapillary capillary (RPC).

Results: In RA patients and HCs, the CPD (%) was 50.99 ± 3.30 and 52.08 ± 2.36 ( = .013) in the SCP, 55.65 ± 5.73 and 57.53 ± 4.60 ( = .019) in the DCP, and 49.98 ± 2.25 and 49.93 ± 2.25 ( = .947) in the RPC blood supply regions, respectively. In inactive and active RA patients, the CPD (%) was 51.01 ± 2.92 and 50.97 ± 3.73 ( = .947) in the SCP, 55.02 ± 5.70 and 56.40 ± 5.74 in the DCP ( = .229), and 50.34 ± 2.23 and 49.55 ± 2.22 ( = .079) in the RPC blood supply regions, respectively. DAS28 was negatively correlated with CPD in RPC blood supply region (Rho = -0.272,  = .006).

Conclusion: In RA, retinal CPD in the macula is lower than HCs. Although retinal CPD is not generally different in active and inactive RA patients, capillaries in the optic disc may be affected by disease activity.