The article recently published in Frontiers in Immunology focused on ocular fundus features, specifically within the retina and choroid, which can potentially help with early diagnosis, the prediction of systemic disease activity, and the involvement of other systems in SLE.

Ocular fundus damage represented the severe type of ocular manifestation in SLE, typically accompanied by significant visual impairment as shown in color fundus images. In SLE patients without ocular manifestations, decreased macular vessel density had been demonstrated by many cohort studies in all layers of the retina, including the superficial capillary plexus (SCP), intermediate capillary plexus (ICP), and deep capillary plexus (DCP) (fig. bottom c-f). Subclinical retinal changes of reduced photoreceptor layer, peripheral retinal nerve fiber layer (RNFL), ganglion cell layer, and inner plexiform layer thickness were revealed by OCT measurements in patients with SLE, thus presenting early signs of retinal neurodegeneration (fig. bottom g-i).

Choroidal changes had also been proven by the decreased macular thickness in patients with juvenile SLE without ocular manifestations compared to age- and sex-matched controls. Reductions in the choroidal vascular index (CVI) and the photoreceptor cell layer thickness had also been observed in eyes with drusen-like deposits (DLDs) but without ocular symptoms, likely attributable to immune infiltration causing stromal area expansion and vascular lumen occlusion by immunocomplexes.

Identifying biomarkers for microvascular changes in patients with SLE with multiple fundus imaging might offer a more effective approach to studying the disease state and predicting further systemic damage.

A 400KHz speed full-range swept-source OCTA (BMizar, TowardPi Medical) was used in this study to visualize ultra-wide-field OCTA and high-resolution OCT images. The device provides comprehensive measurements and quantifications for all sizes.

This study was authored by Dr. Lihui Meng, etc. team of Prof. Youxin Chen, Dr. Xinyu Zhao and Dr. Huan Chen, from Peking Union Medical College Hospital, Chinese Academy of Medical Sciences.

Link to the original text: https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2024.1395609/full