Xue Kang, Guo Tingting, Lei Boya, Chen Sheng, Huang Linlin, Zhou Min
Department of Ophthalmology and Shanghai Key Laboratory of Visual Impairment and Restoration, 423137Eye, Ear, and Throat Hospital of Fudan University, Shanghai, China.
Department of Rheumatology, Renji Hospital, School of Medicine, 71140Shanghai Jiao Tong University, Shanghai, China.
Lupus. 2022 Apr;31(5):582-587. doi: 10.1177/09612033221088181. Epub 2022 Mar 26.
To analyze the blood flow in retrobulbar vessels in systemic lupus erythematosus (SLE) by color Doppler imaging (CDI) and to investigate the associations between immunological markers, retinal abnormalities, disease activity, and vascular parameters.
We examined 30 patients with SLE who were aged 32.1 ± 11.6 years with a disease duration of 68.0 ± 55.6 months and 30 participants in a control group. The peak systolic velocity (PSV), end diastolic velocity (EDV), pulsatility index (PI), and resistive index (RI) of the ophthalmic artery (OA), central retinal artery (CRA), and posterior ciliary arteries (PCAs) were determined. Physical and ophthalmic examinations with assessments of immunological markers were performed. All parameters were compared between SLE patients and normal controls while the correlations among parameters were analyzed.
In the SLE group, CDI confirmed blood flow abnormalities in the CRA and PCAs, with significantly lower blood flow velocities and increased RI and PI ( < 0.05). There was a significantly negative correlation between disease duration and EDV in the CRA, PCA, and OA ( = 0.0423, 0.0453, 0.0448). There was also a significant relationship between the SLE Disease Activity Index and the PI of the OA ( = 0.0367). The patients who had received biological agents (Rituximab) had lower EDV in the CRA and PCA ( = 0.0026, 0.028). SLE patients with kidney or CNS involvement had a significant increase in the PI in the OA ( = 0.0287). The PSV and EDV in the CRA were significantly related to creatinine ( = 0.0007 and 0.0418). We also noted a significant decreased EDV in the CRA and an increased RI in the OA among participants positive for anti-dsDNA antibodies ( = 0.0331 and 0.0228).
Retrobulbar circulatory disturbances were detected in SLE patients by CDI. These findings seem likely to affect smaller vessels like the CRA and PCA. However, the presence of measurable changes in the OA is generally indicative of a coexistent nephropathy or central nervous system (CNS) vasculitis. Creatinine, the disease activity index, being positive for anti-dsDNA, and receiving biological agents were associated with measurable changes on the retrobulbar blood flow.
采用彩色多普勒成像（CDI）分析系统性红斑狼疮（SLE）患者球后血管的血流情况，并研究免疫标志物、视网膜异常、疾病活动度与血管参数之间的关联。
我们检查了30例SLE患者，年龄为32.1±11.6岁，病程为68.0±55.6个月，以及30名对照组参与者。测定眼动脉（OA）、视网膜中央动脉（CRA）和睫状后动脉（PCA）的收缩期峰值流速（PSV）、舒张末期流速（EDV）、搏动指数（PI）和阻力指数（RI）。进行了体格检查和眼科检查，并评估了免疫标志物。对SLE患者和正常对照组的所有参数进行比较，同时分析参数之间的相关性。
在SLE组中，CDI证实CRA和PCA存在血流异常，血流速度显著降低，RI和PI升高（P<0.05）。CRA、PCA和OA的病程与EDV之间存在显著负相关（r分别为0.0423、0.0453、0.0448）。SLE疾病活动指数与OA的PI之间也存在显著关系（r=0.0367）。接受生物制剂（利妥昔单抗）治疗的患者CRA和PCA的EDV较低（P分别为0.0026、0.028）。有肾脏或中枢神经系统受累的SLE患者OA的PI显著升高（P=0.0287）。CRA的PSV和EDV与肌酐显著相关（r分别为0.0007和0.0418）。我们还注意到，抗双链DNA抗体阳性的参与者中，CRA的EDV显著降低，OA的RI升高（P分别为0.0331和0.0228）。
通过CDI检测到SLE患者存在球后循环障碍。这些发现似乎可能影响像CRA和PCA这样的较小血管。然而，OA中存在可测量的变化通常表明存在并存的肾病或中枢神经系统（CNS）血管炎。肌酐、疾病活动指数、抗双链DNA阳性以及接受生物制剂治疗与球后血流的可测量变化相关。
