AB0543 Correlation between systemic lupus erythematosus disease activity and ocular signs in ophthalmologically asymptomatic patients

Abstract

BackgroundSystemic lupus erythematosus (SLE) is an autoimmune disease involving different organs and systems. Ocular manifestations of lupus may manifest as a presenting feature of the disease or as a complication that can be sight threatening. Almost any part of the eye and visual pathway can be affected by inflammatory or thrombotic processes yet ophthalmological assesment in those patients may be delayed.ObjectivesDetection of various ocular pathologies in ophthalmologically asymptomatic SLE patients using Optical Coherence Tomography (OCT), Fundus Fluorescein angiography (FFA), and fundus examination, in addition to studying the relation of between detected ocular changes and SLE disease activity assessed by SLEDAI score.Methods26 ophthalmologically asymptomatic SLE patients recruited from Kasr Alainy hospital, Cairo University, and were subjected to comprehensive ocular assessment in the form of the measurement of visual acuity, fundus examination, FFA, and OCT. Hypertensive, diabetic and renal impairment patients were excluded.ResultsSLE patients were 25 females and 1 male, age mean of 25.15 (±8.6)years, SLEDAI mean 14 (±8.3), duration of illness mean 27 (±42.3) months. FFA showed that 38 out of 52 eyes (73%) had signs of pathological changes in the form of splinter haemorrhages, venular occlusion, diffuse mottling and optic nerve leakage and also degenerative changes which indicate chronicity, in the form of hyperflurorescence areas outside the arcades and pre-papillary areas and capillary dropouts. Besides; OCT detected changes in 67.3% of the examined eyes with 26.9% revealing degenerative thinning. There was significant correlation between disease activity and changes detected by FFA (p value 0.017), but neither the fundus findings nor the OCT pathological changes had correlation with disease activity. On the other hand, there was significant correlation between OCT changes and prolonged use of hydroxychloroquine more than 5 years (p value 0.032) and steroid intake for more than 3 month (p value 0.039). There was no correlation between FFA or OCT changes and proteinuria or anti-phospholipid antibodies.Abstract AB0543 – Table 1Relation between disease activity and FFA changesSLEDAINegative FFA changesPositive FFA changesp-value Inactive2 (0.03%)00.017Active12 (23%)38 (73%)Abstract AB0543 – Table 2Relation between Hydroxychloroquine (HXQ) and OCT changesNegative OCT changesPositive OCT changesp-value HXQ<5 years17 (32.6%)27 (51.9%)0.032HXQ≥5 years0.0%8 (15.3%%)Abstract AB0543 – Figure 1Revealing discrepancy between fundus and FFA changes (left), Correlation between SLEDAI score and FFA changes (right)ConclusionsFFA is can detect early retinopathy changes in patients of SLE which cannot be detected by fundus examination. FFA changes are correlating with disease activity. On the other hand, there was no correlation between OCT changes and disease activity. OCT is more sensitive to detect changes from hydroxychloroquine and steroids intake.References[1] Sivaraj, R.R., Durrani, O.M., Denniston, A.K., et al. (2...