Evaluation of subclinical retinopathy and angiopathy with OCT and OCTA in patients with systemic lupus erythematosus
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ORIGINAL PAPER
Evaluation of subclinical retinopathy and angiopathy with OCT and OCTA in patients with systemic lupus erythematosus Mehmed Ug˘ur Is¸ ık . Berkay Akmaz . Fahrettin Akay . Yusuf Ziya Gu¨ven . ¨ nay Gercik . Go¨khan Kabadayı . I˙dil Kurut . Servet Akar Dilek Solmaz . O
Received: 26 March 2020 / Accepted: 17 August 2020 Ó Springer Nature B.V. 2020
Abstract Purpose To evaluate the choroidal and retinal layers with optical coherence tomography (OCT) and retinal microvascular structures with optical coherence tomography angiography (OCTA) in systemic lupus erythematosus (SLE) patients. Method In this prospective, cross-sectional and comparative study, a total of 35 SLE patients and 35 healthy control participants were included. SLE patients who were using hydroxychloroquine (HCQ) and/or immunosuppressive agents are evaluated with OCT and OCTA. SLE patients who have no HCQ maculopathy observed in OCT were included in the patient group. Results Mean macular thickness and ganglion cell inner plexiform layer (GC-IPL) thicknesses were thinner in the patient group. When the parameters obtained with OCTA were evaluated, vessel (VD) and M. U. Is¸ ık (&) Department of Ophthalmology, Kastamonu University Faculty of Medicine, Kastamonu, Turkey e-mail: [email protected] B. Akmaz F. Akay Y. Z. Gu¨ven Department of Ophthalmology, ˙Izmir Katip C¸elebi University Atatu¨rk Educating and Research Hospital, I˙zmir, Turkey ¨ . Gercik G. Kabadayı I˙. Kurut S. Akar D. Solmaz O Department of Internal Medicine and Division of Rheumatology, ˙Izmir Katip C¸elebi University Atatu¨rk Educating and Research Hospital, ˙Izmir, Turkey
perfusion density (PD) were significantly lower in the patient group. Central foveal thickness and foveal avascular zone parameters were negatively correlated. In addition, VD and PD, and GC-IPL thicknesses were positively correlated. Conclusion Application of OCTA for the evaluation of microvasculature in SLE patients may be useful in subclinical changes. Keywords Hydroxychloroquine Optical coherence tomography Optical coherence tomography angiography Subclinical retinal changes Systemic lupus erythematosus
Introduction Systemic lupus erythematosus (SLE) is a connective tissue disease that can affect multiple ocular structures, and ocular involvement can be seen in one-third of patients [1, 2]. Among the ocular findings associated with SLE, the most common finding is dry eye, and there are also retinal and choroidal vascular changes, corneal and optic nerve changes [3, 4]. Retinal involvement is the second most common ocular manifestation after dry eye and most frequently associated with vision loss [5]. Retinopathy occurring in SLE is thought to be most commonly due to immune complex-mediated microangiopathy and mostly coincides with the activity phase of SLE [6]. Although not
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as frequent as retinal involvement, the choroid has also been shown to be affected in SLE patients [7–9]. Drugs used in SLE ther
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