Bashiri Hamidreza, Karimi Nooshin, Mostafaei Shayan, Baghdadi Azarakhsh, Nejadhosseinian Mohammad, Faezi Seyedeh Tahereh
Department of Internal Medicine, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Rheumatology Research Center, Tehran University of Medical Sciences, North Amirabad street, Tehran, 1411713137, Iran.
BMC Rheumatol. 2021 Oct 1;5(1):34. doi: 10.1186/s41927-021-00203-5.
Ocular manifestations are common in systemic lupus erythematosus (SLE). Retinopathy has previously been linked to disease severity and might have a significant impact on the patient's quality of life and has also been associated with a poor prognosis in SLE. This study aimed to determine the prevalence of retinopathy among patients who are newly diagnosed with SLE.
In a cross-sectional study, patients diagnosed with SLE at a tertiary referral clinic were assessed for inclusion between March 2016 and March 2017. Patients who had received treatment for SLE at any time were excluded, as well as patients with hypertension, diabetes mellitus, and coagulopathy. Clinical findings and laboratory test results were recorded, and patients were examined by an ophthalmologist for evidence of retinal pathologies. SLE disease activity index was also calculated for all patients.
With 114 patients included in the final analysis, we found a prevalence of 15.8% for retinopathy among newly-diagnosed SLE patients. Cotton-wool spots were the most common finding (78%). Patients with retinopathy had significantly lower hemoglobin levels, C3 and C4 concentrations, and higher ANA and Anti-dsDNA levels. Also, patients with retinopathy had a significantly higher SLE DAI score.
We found a relatively high rate of retinopathy in SLE patients at the time of their initial diagnosis. Our findings suggest that retinopathy is an early manifestation of the disease. Ophthalmologic screening might be considered for SLE patients at the time of diagnosis, especially for those with severe disease. We also encourage researchers to further evaluate the correlation between retinopathy and disease activity, and the prognosis of ocular involvement.
眼部表现常见于系统性红斑狼疮（SLE）。视网膜病变此前已被认为与疾病严重程度相关，可能对患者生活质量有重大影响，并且在SLE中也与预后不良有关。本研究旨在确定新诊断的SLE患者中视网膜病变的患病率。
在一项横断面研究中，于2016年3月至2017年3月期间在一家三级转诊诊所对诊断为SLE的患者进行纳入评估。排除任何时候接受过SLE治疗的患者，以及患有高血压、糖尿病和凝血病的患者。记录临床发现和实验室检查结果，并由眼科医生对患者进行检查以寻找视网膜病变的证据。还为所有患者计算SLE疾病活动指数。
最终分析纳入了114例患者，我们发现新诊断的SLE患者中视网膜病变的患病率为15.8%。棉絮斑是最常见的发现（78%）。患有视网膜病变的患者血红蛋白水平、C3和C4浓度显著更低，ANA和抗双链DNA水平更高。此外，患有视网膜病变的患者SLE DAI评分显著更高。
我们发现SLE患者在初次诊断时视网膜病变发生率相对较高。我们的研究结果表明视网膜病变是该疾病的早期表现。对于SLE患者，尤其是重症患者，在诊断时可考虑进行眼科筛查。我们还鼓励研究人员进一步评估视网膜病变与疾病活动之间的相关性以及眼部受累的预后。
