Retinal and choroidal thickness changes in systemic lupus erythematosus patients: a longitudinal study

Area of Science:

• Ophthalmology
• Rheumatology
• Neuroscience

Background:

• Systemic lupus erythematosus (SLE) can affect various organs, but ocular manifestations are not always apparent.
• Early detection of subclinical ocular changes in SLE is crucial for understanding disease progression.

Purpose of the Study:

• To prospectively evaluate changes in peripapillary retinal nerve fibre layer (pRNFL), macular layers, and choroidal thickness (CT) in SLE patients without overt eye disease.
• To correlate these ocular changes with disease activity, medications, and comorbidities.

Main Methods:

• A prospective cohort study of 68 SLE patients followed for at least 12 months.
• Ophthalmologic examinations with spectral domain-optical coherence tomography (SD-OCT) and autoimmune disease specialist assessments were performed.
• Automatic retinal segmentation analyzed pRNFL and macular layers; CT was manually measured.

Main Results:

• A significant global and temporal inferior pRNFL thinning was observed after 12 months.
• Patients on chronic anticoagulants or antihypertensives showed significantly thinner pRNFL.
• No significant changes were found in macular layers or choroidal thickness.

Conclusions:

• SLE patients exhibit early neurodegeneration signs, indicated by progressive pRNFL reduction.
• Chronic use of anticoagulants or antihypertensives in SLE patients is associated with lower pRNFL, suggesting a detrimental effect of cardiovascular risk factors.