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

Abstract

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.

Altered microvascular density in patients with systemic lupus erythematosus treated with hydroxychloroquine—an optical coherence tomography angiography study

“…As indicated by immunofluorescence and electron microscopy, immune complexes accumulate in the choriocapillaris [ 20 ] and choroidopathy is one of the possible ophthalmic manifestations in patients with SLE [ 21 ]. Choroidal thickness appears to be thinner in SLE patients compared with that in healthy controls using spectral-domain OCT [ 22 ]. In patients with HCQ retinopathy, Ahn et al demonstrated signal void areas on the choriocapillaris in the areas of retinal pigment epithelium defects using OCTA [ 23 ].…”

<p>Choroidal Thickness and microRNA146 in Lupus Nephritis Patients</p>

“…23 Interestingly, previous studies that measured CT in patients with SLE had contradictory results. In a study by Dias-Santos et al, 3 68 SLE patients and 50 healthy controls were involved, measuring CT using EDI at 13 loci at subfovea and 500mirons spacing along the vertical and horizontal meridian. CT in the SLE group in their study appears to be thinner, but not statistically significant when compared to the control group.…”

“…2 SLE can affect the vascular system in many territories including choroidal vessels either by immune complex deposition in the vessel wall and lumen inducing vasculitis or an increased atherosclerotic or thrombotic burden. 3 The choroid has been shown to be affected in SLE patients in many studies. 4,5 The choroid choriocapillaris and the renal glomerular capillaries have similar histology and are similarly affected by systemic diseases.…”

“…4,5 The choroid choriocapillaris and the renal glomerular capillaries have similar histology and are similarly affected by systemic diseases. 3 As Lupus nephritis is a severe clinical form of SLE, choroidal thickness has been found as a tissue marker of high activity in patients with lupus nephritis. 5 Choroidopathy was considered as a direct reflection of inflammatory cells deposition in choriocapillaris.…”

“…5 Choroidopathy was considered as a direct reflection of inflammatory cells deposition in choriocapillaris. 3 The severity of the disease is an important key to decide and maintain a proper treatment, and so many activity indices were proposed. One of these is the SLEDAI (SLE disease activity index), that is considered an important index for disease morbidity.…”