Retinal vasculitis in mixed connective tissue disease. A fluoroangiographic study

Abstract

The eyes of 20 consecutive patients with mixed connective tissue disease (MCTD) were studied by ophthalmologic and retinal fluoroangiographic examinations (RFA) and compared with the findings in 18 consecutive patients with primary Sjögren's syndrome (SS) and 50 with systemic lupus erythematosus (SLE). Six of the 20 MCTD patients had abnormal RFA with thickening of capillary walls that stained and progressively leaked fluorescein. None of these lesions could be seen in ophthalmoscopy, where only one patient had cotton wool spots that in RFA were found to correspond to focal areas of ischemia, probably resulting from capillary lesions. Only one patient with primary SS showed capillary leakage, whereas 13 patients with SLE had RFA abnormalities that included microaneurysms in 9, capillary lesions in 6 and drusen in one. No microaneurysms were found in MCTD patients. The differences between MCTD, SLE and SS patients may reflect differences in the quality, quantity, frequency and chronicity of immune complex formation and deposition in these 3 diseases.