Purpose

To evaluate the retinal vascularity and examine it’s relations with the disease’s clinical features in patients with severe psoriasis.

Methods

Patients with severe psoriasis [psoriasis area and severity index (PASI)>10] who don’t have any history of ocular diseases and didn’t have any systemic treatment in the last year and age and sex matched healthy adults were included in the study. All patients underwent detailed ophthalmological examination including optical coherence tomography (OCT) and OCT angiography (OCTA). Vessel densities (VD) of Superficial (SCP) and deep (DCP) capillary plexus, foveal avascular zone (FAZ) diameter and central retinal thickness (CRT) were compared between patients and healthy controls and the association of these parameters with PASI and other clinical features of the disease were analysed in psoriasis group.

Results

Fifty-two psoriasis patients (13 f, 39 m) with mean age 47.8±13.9 years and 56 healthy controls were included in the study. VD of SCP (mean:50.4%±3.9 vs 51.4%±3.2) and DCP (mean: 52.6%±6.4 vs 55.4%±5.7) were lower in all quadrants in psoriasis group compared to controls (p<0.05). No significant difference were observed in the rest of the analysed parameters. A negative correlation was observed between PASI and VD of SCP (r=0.04), whereas no correlation was observed with VD of DCP and PASI (r=0.2). The presence of psoriatic arthritis (PA) was related with an increased CRT (256±28.6 µm vs 238±11.5 µm, p=0.000) and decreased foveal and para-foveal VD in SCP (respectively, p=0.01, p=0.02).

Conclusions

Severe psoriasis, even without any clinical evidence of eye involvement, causes a decrease in retinal blood flow. Increased disease severity and presence of psoriatic arthritis are related with decreased VD in SCP.