Abstract:AIM:To quantitatively assess the early alterations of retinal and choroidal microcirculation and microstructure in systemic lupus erythematosus(SLE)patients without coexisting retinopathy via ultra-widefield swept-source optical coherence tomography angiography(UWF SS-OCTA).
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.
