Evaluation of structural and microvascular retinal and choroidal changes using optical coherence tomography angiography in rheumatoid arthritis.

Purpose: To evaluate choroidal and retinal ultrastructural and microvascular changes in patients with rheumatoid arthritis (RA) and their association with RA disease activity.

Method: This case-control study included 32 people with RA and 34 healthy people who were matched in terms of age and sex. Participants underwent retinal and choroidal imaging with swept source optical coherence tomography (SS-OCT) and swept source optical coherence tomography angiography (SS-OCTA). Choroidal thickness (CT), choroidal vascularity index (CVI), foveal avascular zone (FAZ) and vessel density (VD) were calculated and compared between patient and control groups.

Results: Subfoveal choroidal thickness (SFCT) and temporal parafoveal choroidal thickness were significantly thicker in patients than controls (p = 0.028, p = 0.045, p = 0.028, p = 0.010). CVI was significantly lower in patients than controls (p = 0.010). FAZ and VD were not different between control and patient groups (p > 0.05 for all).

Conclusion: Our study showed increased SFCT and temporal CT, and decreased CVI in RA patients. While no statistically significant difference was found in FAZ and VD values, a trend toward lower VD values was observed in RA patients compared to the control group. Longitudinal evaluation using OCT and OCTA could contribute to elucidating the progression of retinal and choroidal alterations in RA and their potential effect on visual function.