Evaluation of subclinical retinopathy and angiopathy with OCT and OCTA in patients with systemic lupus erythematosus

Işık, Mehmed Uğur; Akmaz, Berkay; Akay, Fahrettin; Güven, Yusuf Ziya; Solmaz, Dilek; Gerçik, Önay; Kabadayi, G.; Kurut, Idil; Akar, Servet

doi:10.1007/s10792-020-01561-8

Cited by 30 publications

(36 citation statements)

References 27 publications

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“…While several SLE studies showed that the FAZ area was enlarged in SLE patients compared to the control group, two studies showed no change in the FAZ area in SLE patients, similar to our study. 16,23,24,25,32 (Table 6) In our study, although SCP VD in the foveal area was found to be lower in SLE patients than that in the HCs, the size and shape of the FAZ in the SCP area were not affected.…”

Section: Discussionmentioning

confidence: 42%

“…Some studies have investigated subclinical retinal involvement and VD in SLE. 10,12,16,20,[22][23][24][25][26] A brief literature review of OCTArelated findings in SLE patients is shown in Table 6. In our study, DCP VD was found to be significantly lower in SLE patients than in HCs in all areas except the perifoveal temporal area.…”

Section: Discussionmentioning

confidence: 99%

“…Unknown FAZ parameters Forte et al 32 Reduction of the vessel density in the 1 mm central, nasal and temporal subfields of DCP. Increased FAZ area Bao et al 38 Significant decrease in the superficial retinal capillary plexus density Unknown FAZ parameters Isık et al 23 VDs and perfusion densities were significantly lower in the SLE group. No difference in FAZ area Pichi et al 16 Decrease in the vascular density of the superficial capillary plexus Enlargement of the FAZ area Mihailovic et al 24 Significantly reduced VD in the en face superficial capillary plexus Larger FAZ area Arfeen et al 25 Significant lower VD in superficial and deep capillary layers No difference in FAZ area Correlation between disease activity (SLEDAI-2K) and OCTA parameters(authors)…”

Section: Impact Of the Hcq On Vessel Density (Authors) Conigliaro Et ...mentioning

confidence: 99%

“…Conigliaro et al 10 SLEDAI score was inversely correlated with SCP Arfeen et al 25 No correlation between SLEDAI score and VD Pichi et al 16 No correlation between SLEDAI score and VD Qi An et al 20 Negative correlation between SLEDAI and parafoveal DCP Bao et al 38 They calculated SLEDAI, but did not correlate it with VD Is ¸ık et al 23 Did not calculate SLEDAI score Mihailovic et al 24 Did not calculate SLEDAI score Forte et al 32 Did not calculate SLEDAI score Abb: CC: choriocapillaris; DCP: deep capillary plexus; FAZ: foveal avascular zone; HC: healthy control; HCQ: hydroxychloroquine; SCP: superficial capillary plexus; SLE: systemic lupus erythematosus; SLEDAI: the Systemic Lupus Erythematosus Disease Activity Index 2000; VD: vessel density.…”

Section: Impact Of the Hcq On Vessel Density (Authors) Conigliaro Et ...mentioning

confidence: 99%

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Evaluation of subclinical retinal microvascular changes in systemic lupus erythematosus patients using optical coherence tomography angiography and its relationship with disease activity

Ermurat

Koyuncu

2022

Lupus

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Objective This study aimed to investigate subclinical retinal microvascular changes with optical coherence tomography angiography (OCTA) in patients with systemic lupus erythematosus (SLE) and healthy controls (HCs), and to evaluate the relationship between OCTA findings and Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K). Materials and Methods In this study, 47 eyes of SLE and 41 eyes of healthy control (HC) were evaluated. The SLE patients were divided into two subgroups: low disease activity (LDA) (SLEDAI≤5) and high disease activity (HDA) (SLEDAI>6). The results of OCTA were compared between SLE patients and HCs as well as the SLE subgroups. The relationship between OCTA results and SLEDAI-2K was evaluated. Results There were no differences in foveal avascular zone (FAZ) areas between the SLE patients and HCs. Central foveal thickness (CFT) was lower in SLE patients ( p = .046). Superficial capillary plexus (SCP) vessel density (VD) in SLE patients was significantly lower only in the foveal area compared to that in HCs ( p = .006). Deep capillary plexus (DCP) VD in SLE patients was significantly lower in all areas except the temporal parafoveal area compared to that in the HCs. There was no statistically significant difference between SLE groups with LDA and HDA in FAZ or any of the other areas, including SCP and DCP. When the correlation between OCTA findings and SLEDAI-2K was examined, both SCP and DCP VD were found to be negatively correlated. conclusions It was observed that DCP VDs were affected in SLE patients with LDA, and SCP VDs were also affected in addition to DCP with HDA. This suggests that DCP may be the first capillary plexus to be comprised in SLE. VDs were negatively correlated with disease activity. It was concluded that OCTA can be a useful tool in assessing subclinical retinal microvascular pathology and disease activity in patients with SLE.

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Section: Discussionmentioning

confidence: 42%

Section: Discussionmentioning

confidence: 99%

Section: Impact Of the Hcq On Vessel Density (Authors) Conigliaro Et ...mentioning

confidence: 99%

Section: Impact Of the Hcq On Vessel Density (Authors) Conigliaro Et ...mentioning

confidence: 99%

See 2 more Smart Citations

Evaluation of subclinical retinal microvascular changes in systemic lupus erythematosus patients using optical coherence tomography angiography and its relationship with disease activity

Ermurat

Koyuncu

2022

Lupus

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“…Therefore, even though HCQ may lead to retinal and choroidal microvasculature toxicity, it is also possible that HCQ may have a protective role preserving the microvascular ocular structures while reducing the activity of autoimmune diseases. 4,5,11,13,18,19…”

Section: Discussionmentioning

confidence: 99%

New insights in pathogenic mechanism of hydroxychloroquine retinal toxicity through optical coherence tomography angiography analysis

Sargues

Adsuara

Navarro

et al. 2022

European Journal of Ophthalmology

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Introduction There is only a unique report with a small sample size studying hydroxychloroquine (HCQ) retinal toxicity with swept-source (SS) optical coherence tomography angiography (OCTA). The aim of this study was to quantify OCTA quantitative parameters in patients who underwent HCQ therapy. Methods We conducted a retrospective study. The study included 43 eyes of 22 patients taking HCQ for more than 5 years (high-risk group), 57 eyes of 29 patients taking HCQ for 5 years or less (low-risk group) and 25 eyes of 50 age-matched healthy controls. OCTA quantitative parameters (vessel density (VD) and foveal avascular zone (FAZ) area in superficial capillary plexus (SCP), middle capillary plexus (MCP), deep capillary plexus (DCP), total capillary plexus (TCP), and choriocapillaris (CC)) were recorded. Results In the low-risk group, VD in the SCP and MCP was increased compared to control group ( p value <.05). In the high-risk group, VD in the SCP, MCP and TCP was increased ( p value <.05). The subgroup analysis revealed an increased VD at SCP in systemic lupus erythematosus (SLE) high-risk patients, an increased VD at TCP and CC in rheumatoid arthritis (RA) high-risk subjects, and a decreased VD at CC level in the high-risk group patients with Sjögren's syndrome (SS) and connective tissue disease (CTD) ( p value <.05). Furthermore, we demonstrated a significant enlargement of FAZ area at MCP level in the high-risk group patients with SS and CTD ( p value <.05). Conclusion We demonstrated an increase of VD in patients who underwent HCQ treatment, so we suggest that HCQ retinal toxicity is not vascular mediated.

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Macular and peripapillary vessel density alterations in a large series of patients with systemic lupus erythematosus without ocular involvement

Subaşı

Kucuk

San

et al. 2022

Graefes Arch Clin Exp Ophthalmol

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Evaluation of subclinical retinopathy and angiopathy with OCT and OCTA in patients with systemic lupus erythematosus

Cited by 30 publications

References 27 publications

Evaluation of subclinical retinal microvascular changes in systemic lupus erythematosus patients using optical coherence tomography angiography and its relationship with disease activity

Evaluation of subclinical retinal microvascular changes in systemic lupus erythematosus patients using optical coherence tomography angiography and its relationship with disease activity

New insights in pathogenic mechanism of hydroxychloroquine retinal toxicity through optical coherence tomography angiography analysis

Macular and peripapillary vessel density alterations in a large series of patients with systemic lupus erythematosus without ocular involvement

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