Drusen-like Deposits in Young Adults Diagnosed With Systemic Lupus Erythematosus

Invernizzi, Alessandro; Dell’Arti, Laura; Leone, Gaia; Galimberti, Daniela; Garoli, Elena; Moroni, Gabriella; Santaniello, Alessandro; Agarwal, Aniruddha; Viola, Francesco

doi:10.1016/j.ajo.2016.11.014

Cited by 37 publications

(51 citation statements)

References 26 publications

(9 reference statements)

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“…3 The connection between LN and choroidopathy has been studied by a series of authors. [10][11][12] It is thought that the Bruch-RPE choriocapillaris membrane may morphologically resemble the glomerulus. Choriocapillaris may be seen as the capillary tuft of the glomeruli; Bruch's membrane as the basement membrane; and the RPE as the glomerular epithelium.…”

Section: Discussionmentioning

confidence: 99%

Choroid thickness profile in patients with lupus nephritis

Braga

Rothwell

Oliveira

et al. 2019

Lupus

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Background Choroidopathy is a rare manifestation of systemic lupus erythematosus (SLE). This entity is associated with active phases of severe SLE and it is frequently accompanied by acute kidney failure, central nervous system involvement and coagulopathy. Purpose To evaluate the choroid thickness of patients with lupus nephritis (LN) without choroidopathy, and to compare this with that of age-matched SLE patients without LN and healthy control subjects. Study design Cross-sectional case control study. Material and methods Fifteen women with LN in remission phase (study group), 15 women with SLE in remission without LN (SLE control group), and 15 healthy women (healthy control group), without ocular diseases or significant refractive error, were recruited. Full ophthalmological examination and a macular optical coherence tomography in enhanced depth imaging mode were performed. The choroid thickness was measured at nine macular points and six lines of mean choroidal thickness were determined. A comparative analysis between the three groups was performed using the one-way ANOVA test and the paired t-test. The choroid thickness of patients under corticotherapy was also compared to that of patients without corticotherapy. Additionally, the correlation between choroid thickness and disease duration was evaluated using the Pearson analysis. Results The mean macular choroidal thickness was 295.73 ± 67.62 μm in the study group, 233.34 ± 41.01 µm in the SLE control group, and 240.98 ± 37.93 μm in the control group ( p = 0.00006 and p = 0.0003, respectively). Additionally, the choroid thickness was significantly thicker than in the SLE and healthy control groups at the foveal ( p = 0.004 and p < 0.000), nasal ( p < 0.000 and p = 0.001), superior ( p = 0.002 and p < 0.000) and inferior ( p < 0.000 and p = 0.001) mean lines. The choroidal thickness in this group was not associated with the duration of the disease. The subgroup of patients with LN under corticotherapy did not reveal a significantly different choroidal thickness. Conclusion This study suggests a relationship between LN and choroidal changes, which may represent an increased risk for choroidopathy in these patients. Choroid thickening was not related with the duration of the disease. This thickening may be correlated with histopathological changes similar to those occurring in kidney glomeruli.

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Section: Discussionmentioning

confidence: 99%

Choroid thickness profile in patients with lupus nephritis

Braga

Rothwell

Oliveira

et al. 2019

Lupus

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“…Internal structure in soft drusen visible on OCT signify risk for progression,47–51 and approximately 10% of soft drusen may have subclinical (nonexudative) neovascularization 52. A spectrum of RPE elevations now exists 53–59. By the gold standard of histology of clinically documented cases (Fig.…”

Section: Imaging Epidemiology and The Expanding Spectrum Of Drusenmentioning

confidence: 99%

Soft Drusen in Age-Related Macular Degeneration: Biology and Targeting Via the Oil Spill Strategies

Curcio

2018

Invest. Ophthalmol. Vis. Sci.

238

273

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AMD is a major cause of legal blindness in older adults approachable through multidisciplinary research involving human tissues and patients. AMD is a vascularmetabolic-inflammatory disease, in which two sets of extracellular deposits, soft drusen/ basal linear deposit (BLinD) and subretinal drusenoid deposit (SDD), confer risk for end-stages of atrophy and neovascularization. Understanding how deposits form can lead to insights for new preventions and therapy. The topographic correspondence of BLinD and SDD with cones and rods, respectively, suggest newly realized exchange pathways among outer retinal cells and across Bruch's membrane and the subretinal space, in service of highly evolved, eyespecific physiology. This review focuses on soft drusen/BLinD, summarizing evidence that a major ultrastructural component is large apolipoprotein B,E-containing, cholesterol-rich lipoproteins secreted by the retinal pigment epithelium (RPE) that offload unneeded lipids of dietary and outer segment origin to create an atherosclerosis-like progression in the subRPEbasal lamina space. Clinical observations and an RPE cell culture system combine to suggest that soft drusen/BLinD form when secretions of functional RPE back up in the subRPE-basal lamina space by impaired egress across aged Bruch's membrane-choriocapillary endothelium. The soft drusen lifecycle includes growth, anterior migration of RPE atop drusen, then collapse, and atrophy. Proof-of-concept studies in humans and animal models suggest that targeting the ''Oil Spill in Bruch's membrane'' offers promise of treating a process in early AMD that underlies progression to both end-stages. A companion article addresses the antecedents of soft drusen within the biology of the macula.

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“…In a study by Invernizzi A, et al on sixty patients with SLE, DLDs were detected in 40% of SLE similar to our study with respect to the number of sample size. 28 Complement disorders seem to affect the prevalence of DLDs in SLE patients. 29 The earliest retinal abnormality in antimalarial drugs, as Hydroxychloroquine (HCQ), is ganglion cell loss.…”

Section: Discussionmentioning

confidence: 99%

<p>Choroidal Thickness and microRNA146 in Lupus Nephritis Patients</p>

Salah

Makled

Elmekawey

et al. 2020

OPTH

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Purpose: To evaluate the choroidal thickness (CT) in the macular area in patients with lupus nephritis and to compare the results with both non-nephritic patients and normal control. To assess the relation of CT to serum microRNA146, disease duration, activity index, and medications.Patients and Methods: Thirty-five SLE patients and thirty normal healthy controls were enrolled for this cross-sectional prospective study. All participants have undergone optical coherence tomography using RTVue OCT (Optovue Inc., Fremont, CA, USA). The scan used was the macular cross 6-mm line. We measured CT from the posterior edge of the retinal pigment epithelium (RPE) to the choroid-sclera junction at subfovea, and 750 µm both temporal and nasal to the fovea.Results: The mean central subfoveal CT in patients was 275.7 ± 41.0 µm (214-374 µm), and the mean central subfoveal CT in the control group was 364.5± 23.0 µm (323-411µm). There was a significant thinning at all three points in patients compared to the control group (p<0.001, Mann-Whitney U-test). In the patients group, subfoveal choroid in non-nephritic subgroup showed significant thinning compared to nephritic subgroup (p=0.032, Mann-Whitney U-test). Drusen-like deposits (DLDs) were detected in 22.9% (8/35) of patients and none in control (p=.023). MiRNA146 showed a significant positive correlation with nephritic lupus patients (r=0.036, P=0.04). Conclusion:The choroidal thickness was significantly thicker among the nephritic lupus patients as compared to the non-nephritic subgroup. Both SLE patients' subgroups are thinner than normal control. Subfoveal choroidal thickening can be considered a biomarker in nephritic lupus especially in conjunction with an increase in miRNA146a. All SLE patients are at risk of small Drusen-like deposits.

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Drusen-like Deposits in Young Adults Diagnosed With Systemic Lupus Erythematosus

Cited by 37 publications

References 26 publications

Choroid thickness profile in patients with lupus nephritis

Choroid thickness profile in patients with lupus nephritis

Soft Drusen in Age-Related Macular Degeneration: Biology and Targeting Via the Oil Spill Strategies

<p>Choroidal Thickness and microRNA146 in Lupus Nephritis Patients</p>

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