Subclinical choroidal involvement in Systemic Lupus Erythematosus

Area of Science:

• Ophthalmology
• Rheumatology
• Vascular Biology

Background:

• Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease that can affect multiple organs.
• Ocular manifestations in SLE are common, but subclinical changes in the choroid are not well understood.
• Early detection of vascular changes in SLE is crucial for managing potential complications.

Purpose of the Study:

• To evaluate choroidal status in Systemic Lupus Erythematosus (SLE) patients using Optical Coherence Tomography (OCT) and OCT-Angiography.
• To investigate choroidal vascularity index (CVI), choriocapillaris parameters, and choroidal thickness (CT) in SLE patients compared to healthy controls.

Main Methods:

• Cross-sectional study involving 20 SLE patients with disease duration <10 years and no disease activity or ocular involvement.
• Comparison with a demographically similar cohort of 20 healthy subjects.
• Assessment of choroidal vascularity index (CVI), choriocapillaris parameters, and choroidal thickness (CT) using OCT and OCT-Angiography.

Main Results:

• SLE patients exhibited a significantly increased choroidal vascularity index (CVI) compared to healthy controls (p=0.022).
• Choriocapillaris analysis revealed a lower number and smaller total area of signal voids in SLE patients (p=0.037 and p=0.041, respectively).
• No significant differences in choroidal thickness (CT) were observed between groups, though CT showed a negative correlation with disease duration in SLE patients.

Conclusions:

• Subclinical choroidal changes, including increased vascularity, are present in adult SLE patients with inactive disease and no overt ocular manifestations.
• The findings suggest increased choroidal vascularity and alterations in choriocapillaris perfusion in SLE.
• OCT and OCT-Angiography are valuable tools for detecting early, subclinical choroidal changes in SLE.