Retinal changes in patients with idiopathic inflammatory myopathies: A case-control study in the MyoCite cohort

Rachna Aggarwal; R. Naveen; Darpan Thakare; Rohit Shahi; Anamika Kumari Anuja; Ahmad Husain; Maryam Abbasi; Upendra Rathore; Vikas Agarwal; Latika Gupta

doi:10.3389/fmed.2022.1065960

Retinal changes in patients with idiopathic inflammatory myopathies: A case-control study in the MyoCite cohort

Rachna Aggarwal
, R. Naveen
, Darpan Thakare
, Rohit Shahi
, Anamika Kumari Anuja
, Ahmad Husain
, Maryam Abbasi
, Upendra Rathore
, Vikas Agarwal
, Latika Gupta^*

^*Corresponding author for this work

Inflammation and Ageing

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Retinal changes are the window to systemic vasculature. Therefore, we explored retinal changes in patients with Idiopathic inflammatory myopathies (IIM) as a surrogate for vascular health.

Methods: Adult and Juvenile IIM patients (2017 ACR/EULAR criteria), visiting a tertiary care center in 2021 were enrolled for detailed ophthalmic examination in comparison with healthy controls (HC). Patients with conditions that precluded thorough posterior chamber examination were excluded. Scale variables are expressed as median (IQR). Multivariate analysis (binary logistic regression-BLR) was conducted, adjusting for age, gender, and comorbidities besides factors significant in univariate analysis.

Results: 43 patients with IIM [31 females; age 36 (23–45) years; disease duration 5.5 (2-12) months] were enrolled for participation. DM (44%) was the most common diagnosis. IIM patients exhibited frequent attenuation of retinal vessels (32.6 vs. 4.3%, p < 0.001), AV nicking (14 vs. 2.2%, p = 0.053), and vascular tortuosity (18.6 vs. 2.2%, p = 0.012), besides decreased visual acuity (53.5 vs. 10.9%, p<0.001) and immature cataracts (34.9 vs. 2.2%, p < 0.001). Attenuation of vessels [OR 10.9 (1.7–71), p = 0.004] emerged as significantly different from HC after adjusting for covariates in BLR. Notably, adults with IIM were more predisposed to retinal abnormalities [21 (57%) vs. 1 (16%), p = 0.068], especially attenuation of vessels [14(38%) vs. 0(0), p = 0.067] than jIIM. However, no difference was found in retinal features amongst the subtypes of adult IIM, nor did they correlate with MDAAT, MDI, or HAQ-DI.

Conclusion: Retinal microvasculopathy and diminution of vision occur in nearly one-thirds to half of the patients with IIM. Microvasculopathy occurs across subtypes of IIM, and more so in adults, calling for further investigation as a surrogate for damage assessment and potentially even systemic vascular health.

Original language	English
Article number	1065960
Journal	Frontiers in Medicine
Volume	9
DOIs	https://doi.org/10.3389/fmed.2022.1065960
Publication status	Published - 30 Nov 2022

Bibliographical note

Publisher Copyright:
Copyright © 2022 Aggarwal, Naveen, Thakare, Shahi, Anuja, Husain, Abbasi, Rathore, Agarwal and Gupta.

Keywords

idiopathic inflammatory myositis
myopathy
retina
vascular health
vasculopathy

ASJC Scopus subject areas

General Medicine

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10.3389/fmed.2022.1065960Licence: Creative Commons: Attribution (CC BY)

Cite this

@article{6c950419cde54d939942c0604b64b86c,

title = "Retinal changes in patients with idiopathic inflammatory myopathies: A case-control study in the MyoCite cohort",

abstract = "Background: Retinal changes are the window to systemic vasculature. Therefore, we explored retinal changes in patients with Idiopathic inflammatory myopathies (IIM) as a surrogate for vascular health. Methods: Adult and Juvenile IIM patients (2017 ACR/EULAR criteria), visiting a tertiary care center in 2021 were enrolled for detailed ophthalmic examination in comparison with healthy controls (HC). Patients with conditions that precluded thorough posterior chamber examination were excluded. Scale variables are expressed as median (IQR). Multivariate analysis (binary logistic regression-BLR) was conducted, adjusting for age, gender, and comorbidities besides factors significant in univariate analysis. Results: 43 patients with IIM [31 females; age 36 (23–45) years; disease duration 5.5 (2-12) months] were enrolled for participation. DM (44\%) was the most common diagnosis. IIM patients exhibited frequent attenuation of retinal vessels (32.6 vs. 4.3\%, p < 0.001), AV nicking (14 vs. 2.2\%, p = 0.053), and vascular tortuosity (18.6 vs. 2.2\%, p = 0.012), besides decreased visual acuity (53.5 vs. 10.9\%, p<0.001) and immature cataracts (34.9 vs. 2.2\%, p < 0.001). Attenuation of vessels [OR 10.9 (1.7–71), p = 0.004] emerged as significantly different from HC after adjusting for covariates in BLR. Notably, adults with IIM were more predisposed to retinal abnormalities [21 (57\%) vs. 1 (16\%), p = 0.068], especially attenuation of vessels [14(38\%) vs. 0(0), p = 0.067] than jIIM. However, no difference was found in retinal features amongst the subtypes of adult IIM, nor did they correlate with MDAAT, MDI, or HAQ-DI. Conclusion: Retinal microvasculopathy and diminution of vision occur in nearly one-thirds to half of the patients with IIM. Microvasculopathy occurs across subtypes of IIM, and more so in adults, calling for further investigation as a surrogate for damage assessment and potentially even systemic vascular health.",

keywords = "idiopathic inflammatory myositis, myopathy, retina, vascular health, vasculopathy",

author = "Rachna Aggarwal and R. Naveen and Darpan Thakare and Rohit Shahi and Anuja, \{Anamika Kumari\} and Ahmad Husain and Maryam Abbasi and Upendra Rathore and Vikas Agarwal and Latika Gupta",

note = "Publisher Copyright: Copyright {\textcopyright} 2022 Aggarwal, Naveen, Thakare, Shahi, Anuja, Husain, Abbasi, Rathore, Agarwal and Gupta.",

year = "2022",

month = nov,

day = "30",

doi = "10.3389/fmed.2022.1065960",

language = "English",

volume = "9",

journal = "Frontiers in Medicine",

issn = "2296-858X",

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TY - JOUR

T1 - Retinal changes in patients with idiopathic inflammatory myopathies

T2 - A case-control study in the MyoCite cohort

AU - Aggarwal, Rachna

AU - Naveen, R.

AU - Thakare, Darpan

AU - Shahi, Rohit

AU - Anuja, Anamika Kumari

AU - Husain, Ahmad

AU - Abbasi, Maryam

AU - Rathore, Upendra

AU - Agarwal, Vikas

AU - Gupta, Latika

PY - 2022/11/30

Y1 - 2022/11/30

N2 - Background: Retinal changes are the window to systemic vasculature. Therefore, we explored retinal changes in patients with Idiopathic inflammatory myopathies (IIM) as a surrogate for vascular health. Methods: Adult and Juvenile IIM patients (2017 ACR/EULAR criteria), visiting a tertiary care center in 2021 were enrolled for detailed ophthalmic examination in comparison with healthy controls (HC). Patients with conditions that precluded thorough posterior chamber examination were excluded. Scale variables are expressed as median (IQR). Multivariate analysis (binary logistic regression-BLR) was conducted, adjusting for age, gender, and comorbidities besides factors significant in univariate analysis. Results: 43 patients with IIM [31 females; age 36 (23–45) years; disease duration 5.5 (2-12) months] were enrolled for participation. DM (44%) was the most common diagnosis. IIM patients exhibited frequent attenuation of retinal vessels (32.6 vs. 4.3%, p < 0.001), AV nicking (14 vs. 2.2%, p = 0.053), and vascular tortuosity (18.6 vs. 2.2%, p = 0.012), besides decreased visual acuity (53.5 vs. 10.9%, p<0.001) and immature cataracts (34.9 vs. 2.2%, p < 0.001). Attenuation of vessels [OR 10.9 (1.7–71), p = 0.004] emerged as significantly different from HC after adjusting for covariates in BLR. Notably, adults with IIM were more predisposed to retinal abnormalities [21 (57%) vs. 1 (16%), p = 0.068], especially attenuation of vessels [14(38%) vs. 0(0), p = 0.067] than jIIM. However, no difference was found in retinal features amongst the subtypes of adult IIM, nor did they correlate with MDAAT, MDI, or HAQ-DI. Conclusion: Retinal microvasculopathy and diminution of vision occur in nearly one-thirds to half of the patients with IIM. Microvasculopathy occurs across subtypes of IIM, and more so in adults, calling for further investigation as a surrogate for damage assessment and potentially even systemic vascular health.

AB - Background: Retinal changes are the window to systemic vasculature. Therefore, we explored retinal changes in patients with Idiopathic inflammatory myopathies (IIM) as a surrogate for vascular health. Methods: Adult and Juvenile IIM patients (2017 ACR/EULAR criteria), visiting a tertiary care center in 2021 were enrolled for detailed ophthalmic examination in comparison with healthy controls (HC). Patients with conditions that precluded thorough posterior chamber examination were excluded. Scale variables are expressed as median (IQR). Multivariate analysis (binary logistic regression-BLR) was conducted, adjusting for age, gender, and comorbidities besides factors significant in univariate analysis. Results: 43 patients with IIM [31 females; age 36 (23–45) years; disease duration 5.5 (2-12) months] were enrolled for participation. DM (44%) was the most common diagnosis. IIM patients exhibited frequent attenuation of retinal vessels (32.6 vs. 4.3%, p < 0.001), AV nicking (14 vs. 2.2%, p = 0.053), and vascular tortuosity (18.6 vs. 2.2%, p = 0.012), besides decreased visual acuity (53.5 vs. 10.9%, p<0.001) and immature cataracts (34.9 vs. 2.2%, p < 0.001). Attenuation of vessels [OR 10.9 (1.7–71), p = 0.004] emerged as significantly different from HC after adjusting for covariates in BLR. Notably, adults with IIM were more predisposed to retinal abnormalities [21 (57%) vs. 1 (16%), p = 0.068], especially attenuation of vessels [14(38%) vs. 0(0), p = 0.067] than jIIM. However, no difference was found in retinal features amongst the subtypes of adult IIM, nor did they correlate with MDAAT, MDI, or HAQ-DI. Conclusion: Retinal microvasculopathy and diminution of vision occur in nearly one-thirds to half of the patients with IIM. Microvasculopathy occurs across subtypes of IIM, and more so in adults, calling for further investigation as a surrogate for damage assessment and potentially even systemic vascular health.

KW - idiopathic inflammatory myositis

KW - myopathy

KW - retina

KW - vascular health

KW - vasculopathy

UR - https://www.scopus.com/pages/publications/85144091398

U2 - 10.3389/fmed.2022.1065960

DO - 10.3389/fmed.2022.1065960

M3 - Article

AN - SCOPUS:85144091398

SN - 2296-858X

VL - 9

JO - Frontiers in Medicine

JF - Frontiers in Medicine

M1 - 1065960

ER -

Retinal changes in patients with idiopathic inflammatory myopathies: A case-control study in the MyoCite cohort

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

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