Mimier-Janczak Małgorzata Karolina, Kaczmarek Dorota, Proc Krzysztof, Misiuk-Hojło Marta, Kaczmarek Radosław
Department and Clinic of Ophthalmology, Wroclaw Medical University, Poland.
Ophthalmology Clinical Centre Spektrum, Wroclaw, Poland.
Reumatologia. 2023;61(3):161-168. doi: 10.5114/reum/166296. Epub 2023 Jun 12.
The aim was to detect subclinical structural retinal abnormalities in optical coherence tomography (OCT) in ophthalmologically asymptomatic systemic lupus erythematosus (SLE) patients without signs of lupus retinopathy or drug toxicity in fundus examination and in OCT and to assess the relationship between OCT parameters and disease activity, therapy type and burden on other organs to demonstrate the utility of OCT in early retinal impairment in SLE patients.
Cross-sectional study. Thirty-three SLE patients (57 eyes) and 31 healthy individuals (56 eyes) were enrolled in the study. We excluded patients with evidence of lupus retinopathy or hydroxychloroquine (HCQ) toxicity on OCT or fundus examination to reveal any subclinical changes. All patients underwent full ophthalmologic examination in the slit lamp including best corrected visual acuity, tonometry, and OCT. The Kolmogorov-Smirnov distribution test was used to assess the normal distribution in quantitative values. The differences between the individual measured parameters in the groups were analyzed using the Mann-Whitney test. Spearman's rank correlation test was used to assess the correlation between the measured parameters and quantitative clinical data.
There was no difference in the OCT findings between SLE and healthy control groups. Among the study group a negative correlation was found between disease duration and age and retinal nerve fiber layer thickness in the inferior quadrant ( = 0.0063, = 0.0036). No correlations were observed between examined retinal parameters and duration of hydroxychloroquine therapy, hydroxychloroquine as well as chloroquine cumulative dose and disease activity indices.
Optical coherence tomography is a widespread ophthalmic modality used for SLE retinopathy and HCQ toxicity screening. Our study did not demonstrate its clinical potency in diagnosis of subclinical retinal involvement. An optical coherence tomography device seems to be less sensitive in subclinical retinal impairment detection than optical coherence tomography angiography.
目的是在眼科检查无症状、眼底检查无狼疮视网膜病变或药物毒性迹象的系统性红斑狼疮（SLE）患者的光学相干断层扫描（OCT）中检测亚临床视网膜结构异常，并评估OCT参数与疾病活动度、治疗类型以及其他器官负担之间的关系，以证明OCT在SLE患者早期视网膜损伤中的作用。
横断面研究。33例SLE患者（57只眼）和31名健康个体（56只眼）纳入研究。我们排除了在OCT或眼底检查中有狼疮视网膜病变或羟氯喹（HCQ）毒性证据的患者，以发现任何亚临床变化。所有患者均在裂隙灯下行全面眼科检查，包括最佳矫正视力、眼压测量和OCT检查。采用Kolmogorov-Smirnov分布检验评估定量值的正态分布。使用Mann-Whitney检验分析各组个体测量参数之间的差异。采用Spearman等级相关检验评估测量参数与定量临床数据之间的相关性。
SLE组与健康对照组的OCT检查结果无差异。在研究组中，发现疾病持续时间与年龄以及下象限视网膜神经纤维层厚度之间呈负相关（r = 0.0063，P = 0.0036）。未观察到所检查的视网膜参数与羟氯喹治疗持续时间、羟氯喹以及氯喹累积剂量和疾病活动指数之间存在相关性。
光学相干断层扫描是用于SLE视网膜病变和HCQ毒性筛查的广泛应用的眼科检查方法。我们的研究未证明其在诊断亚临床视网膜受累方面的临床效力。光学相干断层扫描设备在检测亚临床视网膜损伤方面似乎不如光学相干断层扫描血管造影敏感。
