应用 SS-OCT/OCTA 定量评估系统性红斑狼疮患者的视网膜及脉络膜血流。
Quantitative evaluation of retinal and choroidal vascularity in systemic lupus erythematosus by SS-OCT/OCTA.
机构信息
Department of Ophthalmology and Shanghai Key Laboratory of Visual Impairment and Restoration, Eye, Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China.
Department of Rheumatology, School of Medicine, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China.
出版信息
Graefes Arch Clin Exp Ophthalmol. 2023 Dec;261(12):3385-3393. doi: 10.1007/s00417-023-06155-5. Epub 2023 Jun 27.
PURPOSE
To evaluate changes in retinal and choroidal vascularity using swept-source optical coherence tomography (SS-OCT) and optical coherence tomography angiography (OCTA) in patients with systemic lupus erythematosus (SLE).
METHODS
In this prospective, cross-sectional study, 48 SLE patients and 40 healthy control (group HC) participants were included. The SLE patients were divided into two subgroups: patients with SLE with no ocular disease (group I) and patients with SLE with signs of retinopathy (group II). The superficial vessel density (SVD), deep vessel density (DVD), peripapillary retinal vessel densities (pRVD), choroidal thickness (ChT), and choroidal vascularity including total choroidal area (TCA), luminal area (LA), stromal area (SA), and choroidal vascularity index (CVI) were measured using SS-OCT/OCTA. Physical and ophthalmic examinations as well as the assessments of immunological markers were performed. The results of SS-OCT/OCTA were compared between group I, group II, and group HC, while the correlations among the parameters were analyzed.
RESULTS
The SVD, DVD, and pRVD were found to be significantly lower in SLE patients than group HC, especially in SLE patients with signs of retinopathy. ChT were found to be significantly higher in group II. CVI was positively correlated with SVD and DVD in the fovea, as well as the foveal and parafoveal thickness. A significant decrease in SVD and DVD in the fovea among subjects positive for anti-dsDNA antibodies was noted.
CONCLUSIONS
The application of OCTA in the evaluation of microvasculature may be useful in subclinical changes. Retinal microvascular density decreased in patients with SLE with greater severity of SLE. Disturbed retinal circulation was related to SLE disease activity, disease duration, CVI, and being positive for anti-dsDNA antibodies. The study results also suggest that SLE with signs of retinopathy may affect the choroid with increases in LA, SA, TCA, and ChT.
目的
利用扫频源光学相干断层扫描（SS-OCT）和光相干断层扫描血管造影（OCTA）评估系统性红斑狼疮（SLE）患者视网膜和脉络膜血管变化。
方法
在这项前瞻性、横断面研究中，纳入了 48 例 SLE 患者和 40 例健康对照（HC 组）参与者。SLE 患者分为两组：无眼部疾病的 SLE 患者（I 组）和有视网膜病变迹象的 SLE 患者（II 组）。使用 SS-OCT/OCTA 测量浅层血管密度（SVD）、深层血管密度（DVD）、视盘周围视网膜血管密度（pRVD）、脉络膜厚度（ChT）以及脉络膜包括总脉络膜面积（TCA）、管腔面积（LA）、基质面积（SA）和脉络膜血管指数（CVI）。进行体格检查和眼科检查，并评估免疫标志物。比较 I 组、II 组和 HC 组之间的 SS-OCT/OCTA 结果，分析各参数之间的相关性。
结果
与 HC 组相比，SLE 患者的 SVD、DVD 和 pRVD 明显降低，尤其是有视网膜病变迹象的 SLE 患者。II 组的 ChT 明显升高。CVI 与黄斑区及旁黄斑区的 SVD 和 DVD 呈正相关。在抗 dsDNA 抗体阳性的患者中，黄斑区 SVD 和 DVD 显著下降。
结论
OCTA 在评估微血管方面的应用可能对亚临床改变有用。SLE 患者视网膜微血管密度随 SLE 严重程度的增加而降低。视网膜循环紊乱与 SLE 疾病活动度、病程、CVI 和抗 dsDNA 抗体阳性有关。研究结果还表明，有视网膜病变迹象的 SLE 可能会影响脉络膜，增加 LA、SA、TCA 和 ChT。
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