Microvascular involvement in systemic sclerosis and systemic lupus erythematosus

Saygın, Didem; Highland, Kristin B.; Tonelli, Adriano R.

doi:10.1111/micc.12440

Cited by 44 publications

(51 citation statements)

References 68 publications

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“…Microvascular alteration including occlusive vasculopathy in patients with SLE is an important issue of the disease and a major cause for morbidity and mortality in these patients [ 12 , 13 ]. Involvement of the posterior segment of the eye usually comes along with poor visual outcomes and is indicative of high disease activity [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Altered microvascular density in patients with systemic lupus erythematosus treated with hydroxychloroquine—an optical coherence tomography angiography study

Mihailovic¹,

Leclaire

Eter³

et al. 2020

Graefes Arch Clin Exp Ophthalmol

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Purpose To evaluate the retinal microvascular density using optical coherence tomography angiography (OCTA) in patients with systemic lupus erythematosus (SLE) treated with hydroxychloroquine (HCQ). Methods Nineteen eyes of 19 patients with SLE (study group) without HCQ retinopathy and 19 eyes of 19 healthy subjects (control group) were included in this study. The study group was divided into patients using HCQ for > 5 years (high-risk group) and < 5 years (low-risk group). The VD data of the 3 × 3 mm OCT angiogram of the superficial capillary plexus (SCP) and the choriocapillaris (VD-CC), the foveal avascular zone (FAZ) area and the central retinal thickness (CRT) were extracted and analyzed. Results VD in the en face SCP was significantly reduced in the high-risk group and the low-risk group compared with that in the control group (p < 0.001, p = 0.001) and in the high-risk group compared with the low-risk group (p = 0.007). Correlation analysis between the cumulative dose of HCQ and the VD of the study group revealed a negative correlation, but no statistical significance (p = 0.074). However, a significant positive correlation was observed for the low-risk group (p = 0.035). In patients with SLE, VD-CC was lower (p = 0.042) and the FAZ area larger (p = 0.019). CRT showed no difference between the groups (p = 0.183). Conclusion In this study, SLE patients showed a reduced VD in both groups. In patients treated with HCQ < 5 years, HCQ might have a protective effect on retinal microvasculature. Analysis of retinal microvascular density using OCTA could be useful in the diagnosis and monitoring of vascular alteration in patients with SLE.

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Section: Discussionmentioning

confidence: 99%

Altered microvascular density in patients with systemic lupus erythematosus treated with hydroxychloroquine—an optical coherence tomography angiography study

Mihailovic¹,

Leclaire

Eter³

et al. 2020

Graefes Arch Clin Exp Ophthalmol

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“…SLE can affect joints, kidneys, serosal membranes, hematological and cardiovascular systems as well as the skin. Cutaneous manifestations include oral ulcers and acute, subacute or chronic lupus rash; LRa is found in 14-48% of patients with SLE [27].…”

Section: Systemic Lupus Erythematosusmentioning

confidence: 99%

Livedo racemosa in neurological diseases: an update on the differential diagnoses

Mitri

Enk

Bersano

et al. 2020

Euro J of Neurology

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Livedo is a net‐like violaceous skin pattern. It can be classified as physiological or pathological. The physiological livedo reticularis usually appears in cold conditions, whereas the pathological and irregular livedo, which persists in warm temperatures, is often labeled as ‘livedo racemosa’. Some neurological pathologies are associated with livedo, most commonly those with an inflammatory component or those derived from systemic disorders. The present review summarizes the most important central and peripheral neurological diseases in pediatric and adult age groups associated with livedo, providing physicians with an overview of the clinical presentation, etiology, diagnosis and management of these conditions.

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“…OCTA bypasses the limitations of other microvascular imaging modalities (nailfold/sublingual capillaroscopy, cutaneous laser Doppler or speckle contrast imaging, renal biopsy, and immunofluorescence) such as nonspecificity, insensitivity, poor reproducibility, speed, lack of quantifiability, and invasiveness. 20 Although more research is needed to elucidate the pattern of SLE retinopathy detectable on OCTA as well as the pathophysiology of this phenomenon, our results provide a starting point for further study and suggest subclinical retinal microvascular pathology is centered in the foveal area and less evident in the parafovea.…”

Section: Discussionmentioning

confidence: 66%

Subclinical Foveal Vasculopathy in Patients With Systemic Lupus Erythematosus Using Optical Coherence Tomography Angiography

Shah

Gabriel

Kedhar

et al. 2019

Journal of VitreoRetinal Diseases

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Purpose: This article identifies subclinical microvascular changes in systemic lupus erythematosus (SLE) patients using vascular perfusion densities derived from optical coherence tomography angiography (OCTA). Methods: A retrospective review was performed on individuals with SLE (10 eyes of 5 patients) and age-matched controls imaged with a spectral-domain OCT system (XR Avanti, Optovue, Inc). A split-spectrum amplitude-decorrelation algorithm (SSADA) generated OCTA of the superficial retinal capillaries, deep retinal capillaries, and foveal avascular zone (FAZ). Skeletonized OCTAs were used to create capillary vessel density (VD) values for each image. VD values were compared with clinical staging, and groups were compared using Kruskal–Wallis and Mann–Whitney tests. Results: Both the superficial (SCP) and deep capillary plexus (DCP) had a statistically significant decrease in VD in the SLE group when compared with the control group ( P < .05). The average VD ± SD for normal individuals in the 3 mm × 3 mm scans was 26.11 ± 1.2 and 37.45 ± 1.8 for the SCP and DCP, respectively. For SLE patients the mean ± SD was 18.46 ± 0.84 and 30.22 ± 1.5 for SCP and DCP, respectively. The mean FAZ was found to be 0.207 mm ± 0.02 for healthy controls and 0.350 mm ± 0.02 for SLE patients ( P < .001). Conclusions: In this paper we demonstrate a significantly enlarged FAZ and decreased VD in a small sample of patients with lupus. The SCP VD demonstrated a dose-response–type negative relationship with increased systemic lupus severity. Larger-sample, prospective studies may allow us to further characterize subclinical SLE pathology with OCTA, and OCTA may further provide a means for monitoring the severity or progression of other microvascular diseases.

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Microvascular involvement in systemic sclerosis and systemic lupus erythematosus

Cited by 44 publications

References 68 publications

Altered microvascular density in patients with systemic lupus erythematosus treated with hydroxychloroquine—an optical coherence tomography angiography study

Altered microvascular density in patients with systemic lupus erythematosus treated with hydroxychloroquine—an optical coherence tomography angiography study

Livedo racemosa in neurological diseases: an update on the differential diagnoses

Subclinical Foveal Vasculopathy in Patients With Systemic Lupus Erythematosus Using Optical Coherence Tomography Angiography

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