Choroidal Thickness and microRNA146 in Lupus Nephritis Patients [Letter]

Dear editor

We have read with great interested the article by Salah et al,¹ concerning the macular choroidal thickness (CT) evaluation in patients with lupus nephritis, compared to both non-nephritic patients and healthy subjects.

We congratulate the authors for their outstanding paper, but we would like to make some comments.

In agreement with the article by Barteselli et al,² cited by the authors, we consider that CT could be influenced by several factors like age, axial length (AL), sex,^3,4 but unfortunately, the authors did not evaluate AL differences among the examined groups; therefore, the CT impact of these data is not known.

Moreover, in the methods section, the authors described a good technique to measure CT, and we agree that the posterior edge of retinal pigment epithelium (RPE) can be easily identified.⁵

Nevertheless, according to Figure 1, it seems that they failed to make a precise measurement, making their results questionable.

In fact, from this figure, it appears that the sub-foveal CT was measured from the Outer photoreceptor segment, whereas nasal and temporal CT were even more difficult to identify, but it seems that they were measured from the area between the interdigitation zone and Bruch’s membrane. In case of future works on this topic, we would like to suggest paying more attention to the line drawing between RPE and the choroid-scleral junction to obtain more consistent CT measurements.