目的：利用超广角扫频源光学相干断层扫描血管成像(UWF SS-OCTA)定量评估不合并视网膜病变的系统性红斑狼疮(SLE)患者的早期视网膜和脉络膜微循环及微结构的变化。

方法：本研究为横断面研究。收集2024年5月至2024年10月于徐州医科大学附属医院就诊的不合并视网膜病变的SLE患者64例64眼(随机选取其中一眼入组)，并选择同期年龄和性别匹配在本院体检健康的人员64名64眼(随机选取其中一眼入组)作为健康对照组，所有参与者均行UWF SS-OCTA检查。比较两组参与者视网膜中央及周边视网膜深层毛细血管层(DCP)、浅层毛细血管层(SCP)、全层视网膜、脉络膜毛细血管层(CC)、脉络膜中大血管层的血流密度(VD)； 脉络膜血管容积(CVV)； 脉络膜血管指数(CVI)； 中央区域以及周边区域视网膜内层、视网膜外层、视网膜整体、脉络膜的厚度。SLE患者根据SLE疾病活动指数(SLEDAI-2K)分为三组：低度及无活动组(SLEDAI-2K≤6)20例20眼； 中度活动组(7结果：SLE组患者周边区域DCP、脉络膜毛细血管层血流密度均较健康对照组下降(均P<0.05)； CVI在中央及周边区域均较健康对照组下降(均P<0.05)。高度活动组中央区域脉络膜毛细血管层血流密度与中度活动组比较有差异(P=0.014)； 低度及无活动组中央区域脉络膜中大血管层血流密度与中度活动组比较有差异(P=0.016)。SLE不同活动度组患者中央区域CVI指数有差异(P=0.038)； 周边区域视网膜外层厚度比较有差异(P=0.035)。

结论：UWF SS-OCTA可较好地显示SLE患者视网膜及脉络膜周边血流变化，在患者未出现视网膜病变时已经观察到周边DCP、脉络膜毛细血管层血流密度下降以及全区域CVI变化，UWF SS-OCTA在识别SLE患者早期视网膜及脉络膜变化方面具有一定价值。

METHODS:Cross-sectional study. Totally 64 cases(64 eyes)that diagnosed as SLE without associated retinopathy at the Affiliated Hospital of Xuzhou Medical University from May to October 2024 were enrolled as the study group(Randomly assign one eye to the study group). Simultaneously, age-and gender-matched healthy individuals were recruited as the control group. All participants underwent UWF SS-OCTA. The deep capillary plexus(DCP), superficial capillary plexus(SCP), total retina, choriocapillaris(CC), as well as the choroidal medium and large vessel density(VD)in both the central and peripheral retinal areas of both groups of patients were compared. Additionally, parameters such as choroidal vascularity volume(CVV), choroidal vascularity index(CVI), thickness of the inner retina, outer retina, entire retina, and choroid in both central and peripheral area. SLE patients were categorized into three subgroups based on the SLE disease activity index(SLEDAI-2K), including 20 cases(20 eyes)in mild-and no-activity group(SLEDAI-2K≤6), 20 cases(20 eyes)in moderate-activity group(7RESULTS:The VD of the DCP and CC in the peripheral region of SLE patients significantly decreased compared with the control group(all P<0.05). Additionally, the CVI was decreased in both the central and peripheral area compared to the control group(all P<0.05). In the central region, the VD of CC was different between the high-activity group and the moderate-activity group(P=0.014), and the VD in the medium-to-large choroidal vascular layer of the central region was different between the mild-and no-activity group and the moderate-activity group(P=0.016). Significant differences were observed in the central region CVI index among the three groups(P=0.038). Additionally, statistically significant variations were detected in outer retinal thickness among the three groups in the peripheral region(P=0.035).

CONCLUSION:UWF SS-OCTA excels at revealing subclinical retinal and choroidal peripheral blood flow changes in SLE patients. Peripheral DCP, CC VD reductions, and region-wide CVI alterations can be observed without retinopathy. Thus, it's valuable for spotting early retinal and choroidal changes in SLE patients.