Choroidal thickness changes in systemic lupus erythematosus patients
Received 13 June 2019
Accepted for publication 19 July 2019
Published 20 August 2019 Volume 2019:13 Pages 1567—1578
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Scott Fraser
Arnaldo Dias-Santos,1–3 Joana Tavares Ferreira,1–3 Sofia Pinheiro,4 João Paulo Cunha,1,3 Marta Alves,5 Ana Luísa Papoila,3,5–6 Maria Francisca Moraes-Fontes,3,7–8 Rui Proença9,10
1Department of Ophthalmology, Centro Hospitalar e Universitário de Lisboa Central, Lisbon, Portugal; 2Department of Ophthalmology, Hospital CUF Descobertas, Lisbon, Portugal; 3NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal; 4Autoimmune Disease Unit, Unidade de Doenças Auto-imunes/serviço Medicina 3, Hospital de Santo António Dos Capuchos, Centro Hospitalar e Universitário de Lisboa Central, Lisbon, Portugal; 5Epidemiology and Statistics Unit, Research Center, Centro Hospitalar e Universitário de Lisboa Central, Lisbon, Portugal; 6CEAUL (Center of Statistics and Applications), Lisbon University, Lisbon, Portugal; 7Autoimmune Disease Unit, Unidade de Doenças Auto-imunes/serviço de Medicina 7.2, Hospital Curry Cabral, Centro Hospitalar e Universitário de Lisboa Central, Lisbon, Portugal; 8Instituto Gulbenkian de Ciência, Oeiras, Portugal; 9Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; 10Faculty of Medicine, University of Coimbra, Coimbra, Portugal
Correspondence: Arnaldo Dias-Santos
Serviço de Oftalmologia, Hospital de Santo António dos Capuchos, Alameda de Santo António dos Capuchos, Lisboa 1169-050, Portugal
Tel +351 21313 6492
Purpose: To compare choroidal thickness (CT) between patients with systemic lupus erythematosus (SLE) without ophthalmologic manifestations and a control group. To study the effects in CT of disease duration, activity index, medication and systemic comorbidities.
Methods: Cross-sectional study where spectral-domain optical coherence tomography with enhanced depth imaging was used to measure CT in 13 locations, subfoveally and at 500-μm intervals along a horizontal and a vertical section from the fovea. Linear regression models were used.
Results: Sixty-eight SLE patients and fifty healthy controls were enrolled. CT multivariable analysis revealed lower values in SLE patients (12.93–26.73 μm thinner) in all locations, except the inferior quadrants (6.48–10.44 μm thicker); however, none of these results reached statistical significance. Contrary to the control group, the normal topographic variation in CT between macular quadrants and from the center to the periphery was not observed in the SLE group. Multivariable analysis in the SLE group alone revealed a significant negative association with anticoagulants (50.10–56.09 μm thinner) and lupus nephritis (40.79–58.63 μm thinner). Contrary to controls, the CT of SLE patients did not respond to changes in mean arterial pressure.
Conclusion: CT in SLE appears to be thinner, particularly in the subset of patients with nephritis and taking anticoagulants, suggesting more advanced systemic vascular disease. Choroidal responses to hemodynamic changes may also be altered in SLE.
Keywords: choroidal thickness, enhanced depth imaging, spectral domain optical coherence tomography, systemic lupus erythematosus
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