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Assessment of superficial and deep retinal vessel density in systemic lupus erythematosus patients using optical coherence tomography angiography

  • Inflammatory Disorders
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Abstract

Purpose

The aim of this study is to evaluate the retinal microvascular density in SLE patients using optical coherence tomography angiography (OCTA) and to correlate vascular density with the disease activity and damage risk.

Methods

Twenty eyes of 20 SLE patients were compared with 20 eyes of normal subjects. The retinal capillary plexuses were examined by OCTA. The disease activity and damage risk were evaluated by the SLEDAI-2 K and SLICC/ACR SDI scoring systems.

Results

No difference was found between SLE patients’ central foveal thickness (CFT) and foveal avascular zone (FAZ) area and the normal (P > 0.05). SLE patients had slightly lower superficial vessel densities than normal in the upper and lower macular regions (P < 0.05), sparing the middle sectors (P > 0.05). In the deep plexus, vessel density loss was detected in all sectors (P < 0.001). The vessel density in 300-μm-wide region around the FAZ (FD-300) and the acircularity index (AI) were affected in the SLE in comparison to the normal group (P < 0.05). No significant correlation was found between the SLEDAI-2 k and the retinal vessel density in either layer, while the SLICC/SDI had moderate inverse correlation with vessel density in some sectors (P < 0.05). Receiver operating characteristic (ROC) curve analysis showed that the deep capillary plexus had high sensitivity and specificity for detecting vascular damage in SLE patients.

Conclusions

OCTA permits noninvasive quantitative assessment of retinal vessel density in SLE, allowing early detection of altered retinal circulation. Vessel density could be included in future assessment of SLE activity and damage scores.

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Acknowledgments

We would like to thank Dr. Ahmed Essam-Eldeen Faseeh for his efforts in collecting the data from the patients of this study.

Funding

Self-funded by the authors.

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Authors and Affiliations

  1. Department of Ophthalmology, Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt

    Shaimaa A. Arfeen, Nermeen Bahgat, Nehal Adel & Mohamed M. Khafagy

  2. Department of Rheumatology and Rehabilitation, Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt

    Mervat Eissa

Authors
  1. Shaimaa A. Arfeen
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  2. Nermeen Bahgat
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  3. Nehal Adel
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  4. Mervat Eissa
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  5. Mohamed M. Khafagy
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Shaimaa Arfeen, Mohamed Khafagy, Mervat Eissa and Nermeen Bahgat. The Statistical analysis was carried out by Mohamed Khafagy. The first draft of the manuscript was written by Shaimaa Arfeen and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Mohamed M. Khafagy.

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Conflict of interest

The authors declare that have no conflict of interest.

Ethical approval

All procedures performed in the study were in accordance with the ethical standards of Kasr Al Ainy School of Medicine ethical committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Arfeen, S.A., Bahgat, N., Adel, N. et al. Assessment of superficial and deep retinal vessel density in systemic lupus erythematosus patients using optical coherence tomography angiography. Graefes Arch Clin Exp Ophthalmol 258, 1261–1268 (2020). https://doi.org/10.1007/s00417-020-04626-7

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  • DOI: https://doi.org/10.1007/s00417-020-04626-7

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