Choroidal Thickness in Multisystemic Autoimmune Diseases Without Ophthalmologic Manifestations

Ferreira, Carla; Beato, João; Falcão, Manuel; Brandão, Elisete; Falcão‐Reis, Fernando; Carneiro, Ângela

doi:10.1097/iae.0000000000001193

Cited by 53 publications

(41 citation statements)

References 35 publications

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“…The relation between the duration or cumulative dosage of HCQ and CT has provided inconsistent results in previous publications. 14,35 In our study, we did not observe a significant association between HCQ treatment duration or cumulative dosage and CT.…”

Section: Discussioncontrasting

confidence: 73%

“…9 In recent years, this technique enabled us to characterize the morphology and thickness of the choroid in several ocular and systemic pathologies. [10][11][12] However, only a very limited number of publications have evaluated the choroid in SLE patients using EDI SD-OCT. [13][14][15][16] These studies had heterogeneous samples and presented contradictory results.…”

Section: Introductionmentioning

confidence: 99%

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<p>Choroidal thickness changes in systemic lupus erythematosus patients</p>

Dias‐Santos

Ferreira

Pinheiro

et al. 2019

OPTH

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Purpose: To compare choroidal thickness (CT) between patients with systemic lupus erythematosus (SLE) without ophthalmologic manifestations and a control group. To study the effects in CT of disease duration, activity index, medication and systemic comorbidities. Methods: Cross-sectional study where spectral-domain optical coherence tomography with enhanced depth imaging was used to measure CT in 13 locations, subfoveally and at 500-µm intervals along a horizontal and a vertical section from the fovea. Linear regression models were used. Results: Sixty-eight SLE patients and fifty healthy controls were enrolled. CT multivariable analysis revealed lower values in SLE patients (12.93-26.73 µm thinner) in all locations, except the inferior quadrants (6.48-10.44 µm thicker); however, none of these results reached statistical significance. Contrary to the control group, the normal topographic variation in CT between macular quadrants and from the center to the periphery was not observed in the SLE group. Multivariable analysis in the SLE group alone revealed a significant negative association with anticoagulants (50.10-56.09 µm thinner) and lupus nephritis (40.79-58.63 µm thinner). Contrary to controls, the CT of SLE patients did not respond to changes in mean arterial pressure. Conclusion: CT in SLE appears to be thinner, particularly in the subset of patients with nephritis and taking anticoagulants, suggesting more advanced systemic vascular disease. Choroidal responses to hemodynamic changes may also be altered in SLE.

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Section: Discussioncontrasting

confidence: 73%

Section: Introductionmentioning

confidence: 99%

<p>Choroidal thickness changes in systemic lupus erythematosus patients</p>

Dias‐Santos

Ferreira

Pinheiro

et al. 2019

OPTH

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“…Thickening of the choroid, possibly caused by an infiltration of the choroid by inflammatory cells, has been demonstrated in the active phases of Vogt–Koyanagi–Harada disease (VKH), Behçet's disease, sympathetic ophthalmia, and posterior scleritis [21–25]. Moreover, choroidal thickness seems to be subclinically involved in some systemic inflammatory diseases without ophthalmologic manifestations [26].…”

Section: Introductionmentioning

confidence: 99%

Increased Choroidal Thickness in Keratoconus Patients: Perspectives in the Disease Pathophysiology

Pinheiro-Costa

Pinto

Perestrelo

et al. 2019

Journal of Ophthalmology

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Purpose To analyze and compare choroidal thickness between keratoconus (KC) patients and age-matched non-KC subjects. Methods A cross-sectional, case-control study. One hundred and thirty-four keratoconic eyes and 78 control eyes, from individuals aged from 12 to 30 years old, were studied. Patients with KC followed in Corneal Department of Centro Hospitalar São João, Porto, Portugal, were identified and consecutively included between December 2017 and February 2018. A spectral-domain optical coherence tomography (OCT) using depth enhanced imaging was performed, and choroidal thickness in the center of the fovea and at 500 μm intervals along a horizontal section was measured and compared. Results The statistical analysis showed that keratoconic eyes present a thicker choroid in every measured location (p < 0.05). Mean subfoveal choroidal thickness (SFCT) values obtained were 375.86 ± 89.29 and 322.91 ± 85.14 in keratoconus and control groups, respectively (p < 0.001). In a multivariate analysis, SFCT was significantly associated with spherical equivalent (p=0.004) and the presence of keratoconus (p < 0.001), but not with age (p=0.167), gender (p=0.579), or best-corrected visual acuity (p=0.178). In a “fixed model,” keratoconus patients were found to have a 67.55 μm (95% CI 36.61–98.49) thicker subfoveal choroid compared to controls. Conclusion Keratoconus patients seem to have a thicker choroid than healthy individuals. The exact pathophysiological mechanism resulting in a thicker choroid in KC patients is not known, but it could possibly be associated with inflammatory choroidal mechanisms.

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“…According to Altinkaynak et al SLE patients had thinner choroids than age and gender-matched controls [85]. On the other hand, Ferreira et al reported thicker choroids in these patients [86]. This difference may be due to the systemic disease activity state as in the first study all patients were "inactive" whereas in the latter study the disease activity state was not accessed.…”

Section: Spectral Domain Optical Coherence Tomographymentioning

confidence: 95%

The role of ophthalmic imaging in central nervous system degeneration in systemic lupus erythematosus

Dias‐Santos

Proença

Ferreira

et al. 2018

Autoimmunity Reviews

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Systemic lupus erythematosus (SLE) is an autoimmune connective tissue disorder that can involve any organ system. Central nervous system involvement can be a severe life threatening complication, ultimately resulting in severe neurodegenerative changes. Magnetic resonance imaging suggests that neurodegeneration, which may have deleterious effects on brain function, may occur early in SLE and experimental models suggest that neuroprotection may be feasible and beneficial. The retina is an extension of the brain. Recent ophthalmic imaging technologies are capable of identifying early changes in retinal and choroidal morphology and circulation that may reflect CNS degeneration. However, their utility in monitoring CNS involvement in SLE has been poorly studied as these have only been performed in small cohorts, in a cross-sectional design, non-quantitatively and without correlation to disease activity. The authors aim to review the current understanding of neurodegeneration associated with SLE, with particular focus on the visual pathway. We describe the neuropathology of the visual system in SLE and the evidence for retinal and choroidal neurodegenerative and microvascular changes using optical coherence tomography technology. We aim to describe the potential role of optical imaging modalities in NPSLE diagnosis and their likely impact on the study of neuronal function.

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Choroidal Thickness in Multisystemic Autoimmune Diseases Without Ophthalmologic Manifestations

Abstract: The choroid may be subclinically involved in autoimmune diseases. However, the choroidal response seems to differ depending on the autoimmune disease. Infiltrative mechanisms specific for lupus may justify the thickened choroid found in these patients.

Cited by 53 publications

References 35 publications

<p>Choroidal thickness changes in systemic lupus erythematosus patients</p>

<p>Choroidal thickness changes in systemic lupus erythematosus patients</p>

Increased Choroidal Thickness in Keratoconus Patients: Perspectives in the Disease Pathophysiology

The role of ophthalmic imaging in central nervous system degeneration in systemic lupus erythematosus

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