Scleral changes in systemic lupus erythematosus patients using swept source optical coherence tomography

Area of Science:

• Ophthalmology
• Rheumatology
• Medical Imaging

Background:

• Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with potential multi-organ involvement.
• Ocular manifestations in SLE can occur even without clinically evident scleritis or episcleritis.
• Early detection of subclinical changes is crucial for managing SLE complications.

Purpose of the Study:

• To investigate scleral thickness in SLE patients without apparent ocular inflammation using SS-OCT.
• To compare scleral thickness between SLE patients and healthy controls.
• To explore correlations between scleral thickness and SLE disease characteristics.

Main Methods:

• A cross-sectional study involving 73 SLE patients and 48 healthy volunteers.
• Swept-source optical coherence tomography (SS-OCT) was used to measure nasal and temporal scleral thickness at specific distances from the scleral spur.
• Correlation analysis was performed with laboratory markers, disease duration, disease activity, and organ involvement.

Main Results:

• SLE patients exhibited significantly greater scleral thickness across all measured sites compared to controls (p < 0.001).
• Shorter disease duration (≤5 years) was associated with increased scleral thickness in SLE patients.
• Higher erythrocyte sedimentation rate (ESR) correlated with thinner temporal scleral thickness, while other parameters showed no significant association.

Conclusions:

• SS-OCT reveals increased scleral thickness in SLE patients, even in the absence of clinical scleritis.
• Scleral thickness changes are linked to SLE disease duration and ESR.
• SS-OCT is a valuable tool for detecting asymptomatic scleral abnormalities in SLE, aiding in early evaluation.