Microvasculature alterations of peripapillary retina and macula in systemic lupus erythematosus patients without ocular involvement by optical coherence tomography angiography

Abstract

Purpose: To evaluate microvasculature alterations of the peripapillary retina (PR) and macula and to assess if the changes can detect preclinical retinopathy in systemic lupus erythematosus (SLE) patients. Methods: Cross-sectional study of 32 SLE patients without retinopathy and 22 normal controls. Optical coherence tomography angiography was used to measure the microvasculature of the PR and macula. Vessel densities (VD, %) and fractal dimensions of superficial capillary plexus (SCP) and deep capillary plexus (DCP) were calculated. Results: Compared to controls, macular VD of the whole image SCP (mVD of SCP-wi) and mVD of inferior SCP (mVD of SCP-i) were significantly reduced in SLE patients (p<0.05). The peripapillary VD (pVD) of a 2.5mm circle of SCP (pVD of SCPΦ2.5), pVD of SCPΦ3.5, and pVD of inferior region of the inner circle of SCP (pVD of SCP-ii) were significantly reduced in patients treated with hydroxychloroquine (HCQ) >5 years. mVD of SCP-wi declined with age (β=-0.12; p<0.01) and pVD of SCP-ii declined with hydroxychloroquine cumulative dose (β=-0.01; p<0.01). mVD of SCP-i had the best discrimination power of 0.77 (p<0.01). Conclusion: SLE patients without ocular involvement had microvasculature alterations that were particularly evident in the SCP. PR microvasculature may be reduced in patients with longer HCQ treatment.