Retinal microvascular changes in systemic lupus erythematosus assessed by optical coherence tomography angiography

Purpose: To assess the retinal microvasculature of Systemic Lupus Erythematosus (SLE) patients using Optical Coherence Tomography Angiography (OCTA).

Methods: Twenty adult SLE patients without disease activity and no ocular manifestations were recruited and cross-sectionally assessed. A demographically similar cohort of healthy subjects was used for comparison. The main outcome is vascular density (VD). As secondary outcomes, foveal avascular zone (FAZ) parameters, total vessel length (TVL), vessel length density (VLD), vessel diameter and tortuosity, branchpoint density (BD) and fractal dimension (FD) were evaluated.

Results: Forty eyes of 40 women (20 SLE patients and 20 healthy subjects) were enrolled with a mean ± SD age of 36.7 ± 9.9 years. In both the superficial and deep capillary plexuses, SLE patients presented significantly lower VD and TVL values, mean vessel diameter and FD (all p < 0.005). No significant differences were found in FAZ values. A negative correlation was found between age and FAZ parameters and between age and TVL, VLD and FD in the superficial capillary plexus (all p < 0.05).

Conclusions: This study supports the evidence of subclinical retinal microvascular changes in adult SLE patients, providing a more comprehensive characterization of vascular changes. We found vessel diameter and length and FD are decreased in SLE.

Trial registration: NCT05863689, 2023-10-19.