Choroidal thickness changes in systemic lupus erythematosus patients

Abstract

Purpose: To compare choroidal thickness (CT) between patients with systemic lupus erythematosus (SLE) without ophthalmologic manifestations and a control group. To study the effects in CT of disease duration, activity index, medication and systemic comorbidities. Methods: Cross-sectional study where spectral-domain optical coherence tomography with enhanced depth imaging was used to measure CT in 13 locations, subfoveally and at 500-μm intervals along a horizontal and a vertical section from the fovea. Linear regression models were used. Results: Sixty-eight SLE patients and fifty healthy controls were enrolled. CT multivariable analysis revealed lower values in SLE patients (12.93–26.73 μm thinner) in all locations, except the inferior quadrants (6.48–10.44 μm thicker); however, none of these results reached statistical significance. Contrary to the control group, the normal topographic variation in CT between macular quadrants and from the center to the periphery was not observed in the SLE group. Multivariable analysis in the SLE group alone revealed a significant negative association with anticoagulants (50.10–56.09 μm thinner) and lupus nephritis (40.79–58.63 μm thinner). Contrary to controls, the CT of SLE patients did not respond to changes in mean arterial pressure. Conclusion: CT in SLE appears to be thinner, particularly in the subset of patients with nephritis and taking anticoagulants, suggesting more advanced systemic vascular disease. Choroidal responses to hemodynamic changes may also be altered in SLE.