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使用增强深度成像光谱域光学相干断层扫描和光学相干断层扫描血管造影术对系统性红斑狼疮患者脉络膜病变的研究

Choroidopathy in patients with systemic lupus erythematosus using enhanced depth imaging spectral domain optical coherence tomography and optical coherence tomography angiography.

作者信息

Bayuk Emine Gökçen, Doğuizi Sibel, Erden Abdulsamet, Karakaş Özlem, Çakar Özdal Pınar

机构信息

Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara 06230, Türkiye.

Rheumatology Department, Ankara Bilkent City Hospital, Ankara 06800, Türkiye.

出版信息

Int J Ophthalmol. 2025 Jun 18;18(6):1053-1063. doi: 10.18240/ijo.2025.06.11. eCollection 2025.

Abstract

AIM

To evaluate the choroidopathy in patients with systemic lupus erythematosus (SLE) using enhanced depth imaging spectral domain optical coherence tomography (EDI SD-OCT) and optical coherence tomography angiography (OCTA).

METHODS

A total of 74 patients with SLE and 40 healthy volunteers were included in this cross-sectional study. SLE patients were further divided into three subgroups based on clinical and blood biochemistry findings. Ocular parameters obtained on ophthalmologic examination and optical imaging (EDI SD-OCT and OCTA) included the best corrected distance visual acuity (logMAR CDVA), subfoveal choroidal thickness (SCT), choroidal vascularity index (CVI) and vessel density (VD) of superficial capillary plexus (SCP) and deep capillary plexus (DCP).

RESULTS

SLE patients had significantly lower values for CVI and VD of DCP (DVD) than control subjects. Amongst SLE patients, gender and chloroquine dose were found to be independent determinants of CVI while age predicted SCT. Steroid dose was a significant predictor for foveal VD of SCP (SVD), chloroquine dose for parafoveal SVD, gender for total DVD, and gender and steroid dose for perifoveal DVD. No correlation of logMAR CDVA and SCT was noted between SLE patients and control subjects. No correlation of SCT was noted with disease duration, Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score, hydroxychloroquine (HCQ) dose or steroid dose. No correlation of CVI was noted with patient age, disease duration, SLEDAI score, HCQ dose or steroid dose. No significant difference was noted between SLE subgroups in terms of any of the ocular parameters studied.

CONCLUSION

The findings reveal the presence of ocular findings suggestive of early onset choroidopathy on EDI SD-OCT and OCTA in SLE patients, in the absence of ocular manifestations or active disease.

摘要

目的

使用增强深度成像光谱域光学相干断层扫描(EDI SD-OCT)和光学相干断层扫描血管造影(OCTA)评估系统性红斑狼疮(SLE)患者的脉络膜病变。

方法

本横断面研究共纳入74例SLE患者和40名健康志愿者。根据临床和血液生化检查结果,SLE患者进一步分为三个亚组。眼科检查和光学成像(EDI SD-OCT和OCTA)获得的眼部参数包括最佳矫正远视力(logMAR CDVA)、黄斑下脉络膜厚度(SCT)、脉络膜血管指数(CVI)以及浅表毛细血管丛(SCP)和深部毛细血管丛(DCP)的血管密度(VD)。

结果

SLE患者DCP的CVI和VD值(DVD)显著低于对照组。在SLE患者中,性别和氯喹剂量是CVI的独立决定因素,而年龄可预测SCT。类固醇剂量是SCP黄斑区VD(SVD)的重要预测因素,氯喹剂量是黄斑旁SVD的预测因素,性别是总DVD的预测因素,性别和类固醇剂量是黄斑周DVD的预测因素。SLE患者与对照组之间logMAR CDVA和SCT无相关性。SCT与疾病持续时间、系统性红斑狼疮疾病活动指数(SLEDAI)评分、羟氯喹(HCQ)剂量或类固醇剂量无相关性。CVI与患者年龄、疾病持续时间、SLEDAI评分、HCQ剂量或类固醇剂量无相关性。在所研究的任何眼部参数方面,SLE亚组之间均未发现显著差异。

结论

研究结果显示,在无眼部表现或活动性疾病的SLE患者中,EDI SD-OCT和OCTA检查发现存在提示早期脉络膜病变的眼部表现。

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Systemic lupus erythematosus.系统性红斑狼疮。
Lancet. 2024 May 25;403(10441):2326-2338. doi: 10.1016/S0140-6736(24)00398-2. Epub 2024 Apr 17.
6
Systemic Lupus Erythematosus: New Diagnostic and Therapeutic Approaches.系统性红斑狼疮:新的诊断与治疗方法
Annu Rev Med. 2023 Jan 27;74:339-352. doi: 10.1146/annurev-med-043021-032611. Epub 2022 Jul 8.
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One year in review 2022: systemic lupus erythematosus.2022 年回顾:系统性红斑狼疮。
Clin Exp Rheumatol. 2022 Jan;40(1):4-14. doi: 10.55563/clinexprheumatol/nolysy. Epub 2022 Jan 28.

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