Maitiyaer Maierhaba, Zhang Jingyu, Li Peiyi, Jiang Dingwen, Li Huangdong, Lin Zeying, Ye Ziguan, Huo Yongbao, Huang Wenhui, Wang Li, Liu Zhiping, Yu Shuilian
Department of Rheumatology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.
Ophthalmic Center, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.
Front Immunol. 2025 Jun 16;16:1511133. doi: 10.3389/fimmu.2025.1511133. eCollection 2025.
Systemic lupus erythematosus (SLE) and lupus nephritis (LN) are associated with retinal microvascular changes that may reflect disease severity. This study aimed to evaluate differences in retinal vascular density (VD) between SLE patients with and without LN and assess the impact of rheumatological treatments on VD.
A cross-sectional study was conducted with 54 SLE patients (21 with LN, 33 without LN). Retinal VD was measured using optical coherence tomography angiography (OCTA), focusing on superficial and deep capillary plexus VD (SCP-VD and DCP-VD). The impact of Belimumab and other treatments was analyzed. Linear regression assessed the effects of LN status and treatments on DCP parafoveal VD. Lymphocyte subsets and cytokines were compared before and after Belimumab treatment.
LN patients showed significantly reduced macular vascular density compared with non-LN patients. Belimumab treatment (≥8 times) and hydroxychloroquine use (>5 years) were independently associated with lower DCP-VD, particularly in parafoveal areas. Cumulative doses of HCQ and glucocorticoids negatively correlated with VD. Linear regression showed a significant negative association between Belimumab treatment and parafoveal DCP-VD. Notably, Belimumab treatment led to reductions in serum CD19+ B cells and IL-10 levels.
LN patients demonstrated distinct retinal microvascular alterations. Long-term Belimumab and HCQ treatments were associated with decreased retinal VD. Regular retinal health monitoring was recommended to prevent microvascular complications in SLE patients undergoing prolonged treatment.
系统性红斑狼疮（SLE）和狼疮性肾炎（LN）与视网膜微血管变化有关，这些变化可能反映疾病的严重程度。本研究旨在评估有LN和无LN的SLE患者视网膜血管密度（VD）的差异，并评估风湿性疾病治疗对VD的影响。
对54例SLE患者（21例有LN，33例无LN）进行了一项横断面研究。使用光学相干断层扫描血管造影（OCTA）测量视网膜VD，重点关注浅表和深部毛细血管丛VD（SCP-VD和DCP-VD）。分析了贝利尤单抗和其他治疗的影响。线性回归评估了LN状态和治疗对DCP中心凹旁VD的影响。比较了贝利尤单抗治疗前后的淋巴细胞亚群和细胞因子。
与无LN患者相比，LN患者的黄斑血管密度显著降低。贝利尤单抗治疗（≥8次）和使用羟氯喹（>5年）与较低的DCP-VD独立相关，尤其是在中心凹旁区域。羟氯喹和糖皮质激素的累积剂量与VD呈负相关。线性回归显示贝利尤单抗治疗与中心凹旁DCP-VD之间存在显著负相关。值得注意的是，贝利尤单抗治疗导致血清CD19+B细胞和IL-10水平降低。
LN患者表现出明显的视网膜微血管改变。长期使用贝利尤单抗和羟氯喹治疗与视网膜VD降低有关。建议对接受长期治疗的SLE患者进行定期的视网膜健康监测，以预防微血管并发症。
