Retina and Uveitis Unit, Department of Ophthalmology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
Department of Autoimmune Diseases, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
Rheumatology (Oxford). 2023 Jul 5;62(7):2475-2482. doi: 10.1093/rheumatology/keac626.
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.
This cross-sectional, single-centre study aimed to describe structural changes [macular and retinal nerve fibre layer (RNFL) thickness] by structural spectral-domain optical coherence tomography (SD-OCT) and perifoveal vascular [vessel density (VD) and vascular 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 analysed their association with clinical and laboratory parameters, medications received, disease duration, and SLE activity and damage.
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 aPLs was associated with a decreased RNFL thickness, mainly in the inferior quadrants. Patients developing APS 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.
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 to disease duration. Macular structural parameters were impaired in patients with higher disease damage. APS seems to be associated with preclinical damage to the optic nerve and impairment of the perifoveal microvasculature.
本研究旨在通过光相干断层扫描（OCT）检测 SLE 患者视网膜微血管或视网膜和视神经结构的临床前变化。
这项横断面、单中心研究旨在通过结构谱域光相干断层扫描（SD-OCT）描述结构变化（黄斑和视网膜神经纤维层（RNFL）厚度），并通过 OCT 血管造影（OCTA）评估周边血管[血管密度（VD）和血管灌注（VP）以及黄斑无血管区（FAZ）结构参数]。研究共纳入 78 例 SLE 患者和 80 名健康志愿者。此外，我们还分析了这些参数与临床和实验室参数、接受的药物、疾病持续时间以及 SLE 活动和损伤的相关性。
与对照组相比，SLE 患者的 SD-OCT 结构参数和 OCTA 周边血管参数降低。疾病持续时间>10 年的患者 OCTA 参数（VD、VP 和 FAZ 圆度）和黄斑厚度也降低。存在抗磷脂抗体（aPLs）与 RNFL 厚度降低有关，主要是在下象限。发生 APS 的患者也表现出 RNFL 厚度降低和 OCTA 血流变化。SD-OCT 和 OCTA 结果与疾病活动无关。损伤评分较高的患者黄斑结构参数较低。
SD-OCT 和 OCTA 可检测 SLE 患者的临床前结构和微循环变化。SLE 患者的黄斑结构和周边血管变化与疾病持续时间有关。黄斑结构参数在疾病损伤评分较高的患者中受损。APS 似乎与视神经的临床前损伤和周边微脉管系统损伤有关。
