Evaluation of the choroidal vascularity index and its relationship with disease activity in patients with sjogren's syndrome

Sjogren's syndrome (SS) is a chronic autoimmune disease with involvement of exocrine glands in the foreground. In addition, it may affect many organs including the eye. The choroid, the most vascularised structure of the eye, is affected by many systemic diseases. Choroidal vascularity index (CVI) is a parameter showing vascular damage in systemic diseases. As vascular damage increases, CVI values decrease. In this study, CVI was evaluated in patients diagnosed with SS and in a control group. The aim of this study was to determine whether there is a relationship between SS and disease activation and CVI. In this study, 40 patients with SS between the ages of 18-75 years and 40 healthy controls were included. We evaluated disease activity with Sjögren's syndrome disease activity index (SSDAI). Patients with SSDAI score ≥5 were considered active and those with SSDAI score <5 were considered in remission. Luminal area (LA) and total choroidal area (TCA) were calculated from the enhanced depth imaging optical coherence tomography (EDI-OCT) images of the patients with the help of Image-J software and CVI was measured with the LA/TCA ratio. CVI measurements in patients with SS (mean 0.62±0.04) were significantly lower than CVI measurements in the control group (mean 0.69±0.02) (p=0.0001). No significant difference was found between disease activation measured by SSDAI and CVI value. No significant difference was found between the CVI value and gender, age, disease duration, anti SS-A, anti SS-B, rheumatoid factor (RF) positivity in patients with SS. The CVI value was found to be significantly lower in patients with anti nuclear antibody (ANA) positivity. No significant correlation was found between C reactive protein (CRP) and erythrocyte sedimentation rate (ESR) and CVI values In conclusion, this study demonstrated that CVI values were decreased in SS patients reflecting the vascular involvement of the eye. It was demonstrated that decreased CVI values in SS patients were not related to disease activity. The CVI measurements, which is a non-invasive method, can be used to evaluate the vascular damage triggered by inflammatory processes in the subclinical period in patients with SS.