OP0123 Evaluation of retinal microvasculature by optical coherence tomographic angiography in systemic lupus erythematosus patients mirrors systemic involvement
Authors: P. Conigliaro, M. Cesareo, C. Canofari, G. Aloe, G. Alvaro, P. Triggianese, A.G. Salandri, M.S. Chimenti, R. Perricone
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Optical coherence tomographic angiography (OCTA) is a novel imaging modality that visualises retinal microvasculature in a noninvasive manner. It may have value in managing retinopathy, correlate with visual outcome and mirror systemic involvement in autoimmune diseases. <h3>Objectives</h3> Aim of this study was to evaluate retinal microvasculature in systemic lupus erythematosus (SLE) patients and correlate abnormal vascular maps with disease activity, damage accrual, treatment and visual outcome. <h3>Methods</h3> In a prospective cross-sectional study, OCTA was used to examine density maps, by means of a 6 mm scan, based on superficial retinal layer and deeper retinal layer images in patients and healthy controls (HC) (figure 1A-B) from November 2015 to December 2017. Vessel density, based on a map with vessels of 1-pixel width was measured. <h3>Results</h3> 52 eyes from 26 SLE patients and 40 healthy eyes from 20 HC were imaged (table 1). The eyes from SLE patients had a lower superficial whole en face density, superficial fovea density and superficial parafoveal density (p=0.02 for all comparisons) compared with healthy eyes (figure 1C-E). A negative correlation was demonstrated in SLE patients between age and superficial whole en face density (p=0.0005, r=-0.5), superficial foveal density (p=0.006, r=-0.4), superficial parafoveal density (p=0.004, r=-0.4), deep whole en face density (p=0.003, r=-0.4) and deep parafoveal density (p=0.001, r=-0.4). SLEDAI correlated inversely with superficial en face density (p=0.002, r=-0.4), superficial parafoveal density (p=0.0003, r=-0.5 and p=0.002, r=-0.5), deep whole en face density (p=0.01, r=-0.4) and deep parafoveal density (p=0.002, r=-0.4). A negative correlation was found between SLICC and superficial whole en face density (p=0.0001, r=-0.5), superficial parafoveal density (p&lt;0.0001, r=-0.6), deep whole en face density (p&lt;0.0001, r=-0.6) and deep parafoveal density (p&lt;0.0001, r=-0.7). Patients with nephritis displayed reduced parafoveal vessel density and parafoveal thickness compared to those of patients without nephritis (p=0.02 and p=0.008, figure 1F-G). A positive correlation was found between hydroxychloroquine (HCQ) cumulative dose and both superficial and deep parafoveal density (p=0.009, r=0.4 and p=0.04, r=0.3). Best-corrected visual acuity in SLE positively correlated with superficial whole en face density, superficial parafoveal density, deep whole en face density, and deep parafoveal density (p&lt;0.0001, r=0.7 for all correlations). A negative correlation was found with fovea thickness (p=0.01, r=-0.5). <h3>Conclusions</h3> SLE patients, in particular those with kidney involvement, displayed a reduced retinal microvascular density compared with normal subjects. Vessel density provides a quantitative metric of capillary network that correlated with age, best-corrected visual acuity and clinical features as SLE disease activity and damage accrual. Hydroxychloroquine might have a protective role preserving the microvascular structures. <h3>Disclosure of Interest</h3> None declared