Comparison of Retinal Microvascular Changes in Axial Spondyloarthritis Using Optical Coherence Tomography Angiography: Anti-TNF vs. NSAID Therapy

<b>Objectives</b>: The aim of this study was to investigate retinal and choroidal microvascular changes in patients with axial spondyloarthritis (axSpA) treated with long-term anti-TNF therapy and NSAIDs and in healthy control subjects using optical coherence tomography angiography (SS-O...

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Main Authors: Özlem Karataş, Çisil Erkan Pota, Bülent Akyüz, Yusuf Samet Atlıhan, Kaan Pota, Aslı Çetinkaya Yaprak, Merve Sarı, Serpil Tuna
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/5/597
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author Özlem Karataş
Çisil Erkan Pota
Bülent Akyüz
Yusuf Samet Atlıhan
Kaan Pota
Aslı Çetinkaya Yaprak
Merve Sarı
Serpil Tuna
author_facet Özlem Karataş
Çisil Erkan Pota
Bülent Akyüz
Yusuf Samet Atlıhan
Kaan Pota
Aslı Çetinkaya Yaprak
Merve Sarı
Serpil Tuna
author_sort Özlem Karataş
collection DOAJ
description <b>Objectives</b>: The aim of this study was to investigate retinal and choroidal microvascular changes in patients with axial spondyloarthritis (axSpA) treated with long-term anti-TNF therapy and NSAIDs and in healthy control subjects using optical coherence tomography angiography (SS-OCT-A). <b>Methods</b>: A total of 162 eyes from 81 participants were included: 52 eyes from 26 axSpA patients treated with anti-TNF therapy (≥5 years), 44 eyes from 22 axSpA patients treated with NSAIDs, and 66 eyes from 33 healthy control subjects. SS-OCT-A imaging was used to assess retinal thickness, ganglion cell layer thickness, retinal nerve fiber layer thickness, and the vessel densities of the superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC). Disease activity was assessed with ASDAS-CRP. <b>Results</b>: Both axSpA subgroups showed a significant expansion of the foveal avascular zone and reduced SCP and DCP densities compared to the controls. The CC vessel density was higher in axSpA patients than in healthy subjects. The anti-TNF group had a lower CC vascular density than the NSAIDs group. The disease duration correlated with a decreased central DCP density and increased paracentral SCP and CC densities. <b>Conclusions</b>: SS-OCT-A revealed subclinical retinal and choroidal changes in axSpA patients, highlighting the impact of chronic inflammation on the retinal vasculature. While anti-TNF therapy effectively controls systemic inflammation, it cannot completely prevent microvascular changes. Further studies are needed to assess the clinical relevance of these results.
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issn 2075-4418
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publishDate 2025-03-01
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spelling doaj-art-8d66d96ec8ff4cebb61d1228cdc65a982025-08-20T02:04:36ZengMDPI AGDiagnostics2075-44182025-03-0115559710.3390/diagnostics15050597Comparison of Retinal Microvascular Changes in Axial Spondyloarthritis Using Optical Coherence Tomography Angiography: Anti-TNF vs. NSAID TherapyÖzlem Karataş0Çisil Erkan Pota1Bülent Akyüz2Yusuf Samet Atlıhan3Kaan Pota4Aslı Çetinkaya Yaprak5Merve Sarı6Serpil Tuna7Department of Physical Medicine and Rehabilitation, Akdeniz University, Antalya 07058, TurkeyDepartment of Ophthalmology, Faculty of Medicine, Akdeniz University, Antalya 07058, TurkeyDepartment of Physical Medicine and Rehabilitation, Akdeniz University, Antalya 07058, TurkeyDepartment of Ophthalmology, Faculty of Medicine, Akdeniz University, Antalya 07058, TurkeyDepartment of Orthopaedics and Traumatology, Akdeniz University, Antalya 07058, TurkeyDepartment of Ophthalmology, Faculty of Medicine, Akdeniz University, Antalya 07058, TurkeyDepartment of Internal Medicine, Antalya Training and Research Hospital, Antalya 07058, TurkeyDepartment of Physical Medicine and Rehabilitation, Akdeniz University, Antalya 07058, Turkey<b>Objectives</b>: The aim of this study was to investigate retinal and choroidal microvascular changes in patients with axial spondyloarthritis (axSpA) treated with long-term anti-TNF therapy and NSAIDs and in healthy control subjects using optical coherence tomography angiography (SS-OCT-A). <b>Methods</b>: A total of 162 eyes from 81 participants were included: 52 eyes from 26 axSpA patients treated with anti-TNF therapy (≥5 years), 44 eyes from 22 axSpA patients treated with NSAIDs, and 66 eyes from 33 healthy control subjects. SS-OCT-A imaging was used to assess retinal thickness, ganglion cell layer thickness, retinal nerve fiber layer thickness, and the vessel densities of the superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC). Disease activity was assessed with ASDAS-CRP. <b>Results</b>: Both axSpA subgroups showed a significant expansion of the foveal avascular zone and reduced SCP and DCP densities compared to the controls. The CC vessel density was higher in axSpA patients than in healthy subjects. The anti-TNF group had a lower CC vascular density than the NSAIDs group. The disease duration correlated with a decreased central DCP density and increased paracentral SCP and CC densities. <b>Conclusions</b>: SS-OCT-A revealed subclinical retinal and choroidal changes in axSpA patients, highlighting the impact of chronic inflammation on the retinal vasculature. While anti-TNF therapy effectively controls systemic inflammation, it cannot completely prevent microvascular changes. Further studies are needed to assess the clinical relevance of these results.https://www.mdpi.com/2075-4418/15/5/597axial spondyloarthritisanti-TNF therapyNSAIDsswept-source optical coherence tomography angiographyretinal microvascular changeschoroidal thickness
spellingShingle Özlem Karataş
Çisil Erkan Pota
Bülent Akyüz
Yusuf Samet Atlıhan
Kaan Pota
Aslı Çetinkaya Yaprak
Merve Sarı
Serpil Tuna
Comparison of Retinal Microvascular Changes in Axial Spondyloarthritis Using Optical Coherence Tomography Angiography: Anti-TNF vs. NSAID Therapy
Diagnostics
axial spondyloarthritis
anti-TNF therapy
NSAIDs
swept-source optical coherence tomography angiography
retinal microvascular changes
choroidal thickness
title Comparison of Retinal Microvascular Changes in Axial Spondyloarthritis Using Optical Coherence Tomography Angiography: Anti-TNF vs. NSAID Therapy
title_full Comparison of Retinal Microvascular Changes in Axial Spondyloarthritis Using Optical Coherence Tomography Angiography: Anti-TNF vs. NSAID Therapy
title_fullStr Comparison of Retinal Microvascular Changes in Axial Spondyloarthritis Using Optical Coherence Tomography Angiography: Anti-TNF vs. NSAID Therapy
title_full_unstemmed Comparison of Retinal Microvascular Changes in Axial Spondyloarthritis Using Optical Coherence Tomography Angiography: Anti-TNF vs. NSAID Therapy
title_short Comparison of Retinal Microvascular Changes in Axial Spondyloarthritis Using Optical Coherence Tomography Angiography: Anti-TNF vs. NSAID Therapy
title_sort comparison of retinal microvascular changes in axial spondyloarthritis using optical coherence tomography angiography anti tnf vs nsaid therapy
topic axial spondyloarthritis
anti-TNF therapy
NSAIDs
swept-source optical coherence tomography angiography
retinal microvascular changes
choroidal thickness
url https://www.mdpi.com/2075-4418/15/5/597
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