Retinal and choroidal thickness changes in systemic lupus erythematosus patients: a longitudinal study

Dias‐Santos, Arnaldo; Ferreira, Joana; Pinheiro, Sofia; Cunha, João Paulo; Alves, Marta; Papoila, Ana Luísa; Moraes‐Fontes, Maria Francisca; Proença, Rui

doi:10.1038/s41433-020-01292-1

Cited by 9 publications

(14 citation statements)

References 40 publications

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“…The duration of use was not specified in the following studies, though patients with rheumatological disorders may prescribed chronic regimes of oral corticosteroids. In 1 study, oral corticosteroids were significantly associated with decreased parafoveal CT in patients with systemic lupus erythematous 36 ; 38.8% of patients in this study had active disease. 36 Each mg increase of prednisone equivalent was associated with a 2.4-μm decrease in CT. 36 In another study, corticosteroids were significantly associated with increased CT, with higher doses associated with higher CT. 31 This study examined patients with systemic lupus erythematous, rheumatoid arthritis, nodal osteoarthritis, primary Sjögren syndrome or scleroderma, and did not report disease activity status.…”

Section: Corticosteroidsmentioning

confidence: 48%

“…In 1 study, oral corticosteroids were significantly associated with decreased parafoveal CT in patients with systemic lupus erythematous 36 ; 38.8% of patients in this study had active disease. 36 Each mg increase of prednisone equivalent was associated with a 2.4-μm decrease in CT. 36 In another study, corticosteroids were significantly associated with increased CT, with higher doses associated with higher CT. 31 This study examined patients with systemic lupus erythematous, rheumatoid arthritis, nodal osteoarthritis, primary Sjögren syndrome or scleroderma, and did not report disease activity status. 31 The presence of inflammatory mediators, lymphocytes, immunoglobulins, complements and fibrin deposition in choroidal vessels may cause increased CT, 31 and corticosteroids may decrease CT by dampening the inflammation.…”

Section: Corticosteroidsmentioning

confidence: 48%

“…The effect of thiazides on CT is currently unknown because there has not yet been a study on the association between thiazides and CT. Diuretic use was significantly associated with a decreased CT in patients with systemic lupus erythematous 36 . Neither the specific diuretics nor indications for the diuretics were specified.…”

Section: Resultsmentioning

confidence: 97%

“…[SLE] and rheumatoid arthritis [RA]). 31,36 However, a third study found that CT was significantly increased after 1 year of HCQ in patients with RA. 32 Notably, the patients did not report a significant change in their vision despite the change in CT. 32 Two other studies found that cumulative dose and duration of HCQ use was significantly associated with decrease in SFCT in patients with SLE or RA.…”

Section: Hydroxychloroquinementioning

confidence: 99%

“…Diuretic use was significantly associated with a decreased CT in patients with systemic lupus erythematous. 36 Neither the specific diuretics nor indications for the diuretics were specified.…”

Section: Angiotensin-converting Enzyme Inhibitors Calcium Channel Blo...mentioning

confidence: 99%

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The effect of systemic and topical ophthalmic medications on choroidal thickness: A review

Yeung

Park

et al. 2022

Brit J Clinical Pharma

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The choroid plays an important role in various ocular pathologies and retinal blood supply. There is a knowledge gap on how the choroid is affected by systemic and topical medications. Systemic medications that affect microvasculature elsewhere in the body can also affect the microvasculature of the choroid. This review summarizes current knowledge on associations between systemic and topical medications and changes in choroidal thickness (CT). This review included 71 studies on mydriatics/cycloplegics, intraocular pressure (IOP)‐lowering therapies, antihypertensives, adrenergic antagonists, statins, corticosteroids, hydroxychloroquine, isotretinoin, hormonal contraceptives, phosphodiesterase inhibitors, antipsychotics, antineoplastic agents, ethanol, caffeine and nicotine. IOP‐lowering therapies, atropine eye drops, and systemic administration of β blockers and ethanol are associated with a significant increase in CT. Cyclopentolate and phenylephrine are associated with a CT reduction. Systemic medications that decrease CT include caffeine and nicotine. Tropicamide, angiotensin‐converting enzyme inhibitors, angiotensin receptor blockers, statins, corticosteroids, hydroxychloroquine and hormonal contraceptives have mixed findings. CT increase associated with IOP‐lowering therapies is possibly achieved by enhancing aqueous humour flow to the choroid thus elevating choroidal blood flow and thickness. CT changes appear to be independent from systemic blood pressure changes, suggesting that a significant association with an antihypertensive could be due to an idiosyncratic drug property. Statins and candesartan decrease macrophage accumulation and intercellular adhesion molecule 1 expression in the choroid. The choroid and its response to various disease processes and systemic medication can be further investigated to improve patient care, particularly in patients with choroid and retina pathologies.

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Section: Corticosteroidsmentioning

confidence: 48%

Section: Corticosteroidsmentioning

confidence: 48%

Section: Resultsmentioning

confidence: 97%

Section: Hydroxychloroquinementioning

confidence: 99%

Section: Angiotensin-converting Enzyme Inhibitors Calcium Channel Blo...mentioning

confidence: 99%

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The effect of systemic and topical ophthalmic medications on choroidal thickness: A review

Yeung

Park

et al. 2022

Brit J Clinical Pharma

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Retinal sublayer analysis in juvenile systemic lupus erythematosus without lupus retinopathy

Xu,

Zhang

2024

Clin Rheumatol

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Preclinical ocular changes in systemic lupus erythematosus patients by optical coherence tomography

et al. 2022

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Objectives The aim of the present study was to detect preclinical changes in SLE patients in retinal microvascularization or retinal and optical nerve structure by optical coherence tomography. Methods This cross-sectional, single-center study aimed to describe structural changes (macular and retinal nerve fiber layer [RNFL] thickness) by structural spectral-domain optical coherence tomography (SD-OCT) and perifoveal vascular (vascular density [VD] and perfusion [VP] and foveal avascular zone [FAZ] structural parameters) findings by OCT-angiography (OCTA) in 78 SLE patients and 80 healthy volunteers. In addition, we analyzed their association with clinical and laboratory parameters, medications received, disease duration and SLE activity and damage. Results Structural parameters by SD-OCT and perifoveal vascular parameters by OCTA were decreased in SLE patients compared with controls. OCTA parameters (VD, VP and FAZ circularity) and macular thickness were also decreased in patients with longer disease duration (>10 years). The presence of antiphospholipid antibodies was associated with a decreased RNFL thickness, mainly in the inferior quadrants. Patients developing antiphospholipid syndrome also showed decreased RNFL thickness and OCTA flow changes. SD-OCT and OCTA results were not associated with disease activity. Foveal structural parameters were lower in patients with higher damage score. Conclusion SD-OCT and OCTA can detect preclinical structural and microcirculatory changes in SLE patients. Structural and perifoveal vascular macular changes in SLE patients are related with disease duration. Macular structural parameters were impaired in patients with higher disease damage. Antiphospholipid syndrome seems to be associated with preclinical damage of the optic nerve and impairment of the perifoveal microvasculature.

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Retinal and choroidal thickness changes in systemic lupus erythematosus patients: a longitudinal study

Cited by 9 publications

References 40 publications

The effect of systemic and topical ophthalmic medications on choroidal thickness: A review

The effect of systemic and topical ophthalmic medications on choroidal thickness: A review

Retinal sublayer analysis in juvenile systemic lupus erythematosus without lupus retinopathy

Preclinical ocular changes in systemic lupus erythematosus patients by optical coherence tomography

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