Romatoid Artrit Hastalarında Kardiyovasküler Risk Değerlendirme Yöntemi Olarak Retinal Vasküler Kalibrenin Kullanımı Prospektif Takip Çalışması
Özet
Babaoğlu, Hakan, Use Of Retinal Vascular Calibre Which is A Novel Cardiovascular Risk Analyses Method in Rheumaotid Arhtritis Patients, Prospective Case Control Study. Hacettepe University Departmant of Internal Medicine, Thesis in Internal Medicine, Ankara, 2015. This study aims to investigate retinal vasculer calibre (RVC, a novel cardiovasculer(CV) risk analysis method) differences in Rheumatoid Arthritis (RA) patients compared to SLE patients and agesex-comorbidity equivalent population and the interaction between RVC and disease activity scores and CRP in RA patients. Additionally during follow–up effect of disease activity score, level of inflamation and patients clinical status change to the RVC variation and correlation of these parameters were explored. Fortyseven RA patient according to ACR-EULAR 2010 criteria included in this study between july 2014-january 2015. DAS-28, SDAI, CDAI and HAQ scores were recorded. Thirtytwo SLE patient and 45 controls without known rheumatological disease included. RVC was measured from fundus photographs, and summarised as the central retinal artery and vein equivalents (CRAE- CRVE) using a semi-automated computer-assisted method(IVAN, Wisconsin University). CRAE and CRVE were calculated respectively 147,8±11,7µm, 213,3±17,8µm in RA patients, 147,4±17,6µm, 217,5±26,2µm in control group, 148,3±12,8µm, 209,2±14,1µm in SLE patients. There were no correlation between DAS-28,SDAI, CDAI, CRP, ESR, HAQ score with RVC. But there were significant difference of CRVE levels between the groups determined according to DAS-28(DAS-28≤3,2 vs DAS-28>3,2 p=0,045, DAS-28≤3,2 vs DAS28>5,1 p=0,004). Twentyfour of fortyseven patient evaluateed again 5,2±2,1 months later. There were no correlation between the changes of DAS-28, CRP, HAQ and VASD with the RVC changes of these 24 patients. As a result there were no significant difference in RVC between RA and control group, but CRVE was significantly wider in RA patients than SLE (p=0,038). CRVE which is reflecting systemic inflammation and possibly increased CV risk, significantly increased in RA patients with high disease activity determined by DAS-28 score. There was no correlation between the change of clinical parameters with RVC changes in RA patients during the follow up