scholarly journals Evaluation of Choroidal Thickness, Choroidal Vascularity Index and Peripapillary Retinal Nerve Fiber Layer in Patients with Juvenile Systemic Lupus Erythematosus

Lupus ◽  
2018 ◽  
Vol 28 (1) ◽  
pp. 44-50 ◽  
Author(s):  
A. Ağın ◽  
S. Kadayıfçılar ◽  
H.E. Sönmez ◽  
A. Baytaroğlu ◽  
S. Demir ◽  
...  

Objective The aim of this study was to conduct a detailed ophthalmological examination in children with systemic lupus erythematosus (jSLE), including choroidal thickness (ChT), choroidal vascularity index (CVI) and peripapillary retinal nerve fiber layer (RNFL). Methods The study included all jSLE patients ( n = 21) diagnosed according to the Systemic Lupus International Collaborating Clinics classification criteria between January 2017 and April 2017, and an age- and gender-matched control group ( n = 21). The Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) was used to assess disease activity. After routine eye examinations, ChT at five points (750 µ and 1500 µ from the center of the fovea both in the temporal and nasal quadrants and under the fovea), total subfoveal choroidal area (TCA), luminal area (LA), stromal area (SA), CVI and RNFL thickness at the optic disc were evaluated. Results One patient had active ocular involvement in the form of episcleritis. Another patient had corticosteroid-induced cataract. The median age of the patients was 16 years (6-19 years). ChT at five points, TCA, LA and SA were found to be higher in patients with jSLE, whereas RNFL thickness and CVI were similar to those of the healthy control individuals. No correlation was determined between optical coherence tomography findings, SLEDAI and the immunological parameters (antinuclear antibodies, anti-double-stranded DNA, complements 3 and 4, extracted nuclear antigen antibody, antiphospholipid antibody). Intraretinal and subretinal fluid was not present in any of the patients. Conclusion The choroid was thicker in patients with jSLE than in the control group. The study results suggest that jSLE may affect the choroid. Ophthalmological evaluation is important in SLE patients, even in the absence of relevant complaints.

2021 ◽  
Vol 19 ◽  
pp. 205873922110406
Author(s):  
Kürşad Ramazan Zor ◽  
Tuğba Arslan Gülen ◽  
Gamze Yıldırım Biçer ◽  
Erkut Küçük ◽  
Ayfer İmre ◽  
...  

Introduction This study aims to detect changes in choroidal thickness and retinal nerve fiber layer (RNFL) thickness in acute stage brucellosis. Methods Fnewly diagnosed patients with acute brucellosis and 19 healthy individuals as control group were included in the study. Choroidal thickness and RNFL thickness were measured using the Spectral Domain Cirrus OCT Model 400 (Carl Zeiss Meditec, Jena, Germany) for each participant in the patient and control group. Results In the brucella group, in the right eyes, the mean nasal choroidal thickness was 272.77 ± 50.26 μm ( p = 0.689), the mean subfoveal choroidal thickness was 321.14 ± 33.08 μm ( p = 0.590), the mean temporal choroidal thickness was 278.86 ± 48.84 μm ( p = 0.478), and the mean RNFL thickness was 90.43 ± 8.93 μm ( p = 0.567). In the left eyes, the mean nasal choroidal thickness was 282.29 ± 48.93 μm ( p = 0.715), the mean subfoveal choroidal thickness was 316.79 ± 39.57 μm ( p = 0.540), the mean temporal choroidal thickness was 284.93 ± 50.57 μm ( p = 0.392), and the mean RNFL thickness was 92.64 ± 8.95 μm ( p = 0.813). Conclusion No difference was found between the control and the brucella groups regarding to all choroidal regions and RNFL thickness.


Lupus ◽  
2017 ◽  
Vol 26 (13) ◽  
pp. 1420-1425 ◽  
Author(s):  
S Shulman ◽  
R Shorer ◽  
J Wollman ◽  
G Dotan ◽  
D Paran

Background Cognitive impairment is frequent in systemic lupus erythematosus. Atrophy of the corpus callosum and hippocampus have been reported in patients with systemic lupus erythematosus, and diffusion tensor imaging studies have shown impaired white matter integrity, suggesting that white matter damage in systemic lupus erythematosus may underlie the cognitive impairment as well as other neuropsychiatric systemic lupus erythematosus manifestations. Retinal nerve fiber layer thickness, as assessed by optical coherence tomography, has been suggested as a biomarker for white matter damage in neurologic disorders such as multiple sclerosis, Alzheimer’s disease and Parkinson’s disease. Retinal nerve fiber layer thinning may occur early, even in patients with mild clinical symptoms. Aim The objective of this study was to assess the association of retinal nerve fiber layer thickness, as a biomarker of white matter damage in systemic lupus erythematosus patients, with neuropsychiatric systemic lupus erythematosus manifestations, including cognitive impairment. Methods Twenty-one consecutive patients with systemic lupus erythematosus underwent neuropsychological testing using a validated computerized battery of tests as well as the Rey-Auditory verbal learning test. All 21 patients, as well as 11 healthy, age matched controls, underwent optical coherence tomography testing to assess retinal nerve fiber layer thickness. Correlations between retinal nerve fiber layer thickness and results in eight cognitive domains assessed by the computerized battery of tests as well as the Rey-Auditory verbal learning test were assessed in patients with systemic lupus erythematosus, with and without neuropsychiatric systemic lupus erythematosus, and compared to retinal nerve fiber layer thickness in healthy controls. Results No statistically significant correlation was found between retinal nerve fiber layer thickness in patients with systemic lupus erythematosus as compared to healthy controls. When evaluating by subgroups, no correlation was found between patients with or without neuropsychiatric systemic lupus erythematosus or cognitive impairment and retinal nerve fiber layer thickness. Conclusion Retinal nerve fiber layer thickness of systemic lupus erythematosus patients was not found to be statistically different compared to controls. Within systemic lupus erythematosus patients there was no correlation between retinal nerve fiber layer thickness and cognitive impairment or other neuropsychiatric systemic lupus erythematosus manifestations.


Lupus ◽  
2020 ◽  
Vol 29 (2) ◽  
pp. 182-190
Author(s):  
W Batista Cicarini ◽  
R C Figueiredo Duarte ◽  
K Silvestre Ferreira ◽  
C de Mello Gomes Loures ◽  
R Vargas Consoli ◽  
...  

We have explored the relationship between possible hemostatic changes and clinical manifestation of the systemic lupus erythematosus (SLE) as a function of greater or lesser disease activity according to Systemic Lupus Erythematosus Disease Activity Index-2000 (SLEDAI-2K) criteria. Endothelial injury and hypercoagulability were investigated in patients with SLE by measuring thrombomodulin (TM), D-dimer (DDi) and thrombin generation (TG) potential. A total of 90 participants were distributed into three groups: 1) women with SLE presenting with low disease activity (laSLE) (SLEDAI-2K ≤ 4), 2) women with SLE presenting with moderate to high disease activity (mhaSLE) (SLEDAI-2K > 4), and 3) a control group comprising healthy women. Levels of TM and DDi were higher both in the laSLE and mhaSLE groups compared to controls and in mhaSLE compared to the laSLE group. With respect to TG assay, lagtime and endogen thrombin potential, low concentrations of tissue factor provided the best results for discrimination among groups. Analysis of these data allow us to conclude that TM, DDi and TG are potentially useful markers for discriminating patients with very active from those with lower active disease. Higher SLE activity may cause endothelial injury, resulting in higher TG and consequently a hypercoagulability state underlying the picture of thrombosis common in this inflammatory disease.


2020 ◽  
pp. 112067212098289
Author(s):  
Ceylan Uslu Dogan ◽  
Damla Culha

Objective: Regarding the effect of obesity on subfoveal choroidal thickness (CT) and peripapillary retinal nerve fiber layer (RNFL) thickness, controversial results have been reported in different patient groups. This study aimed to evaluate the effect of obesity on these parameters among young male subjects in comparison with age-matched non-obese healthy males. Methods: This prospective, cross-sectional study included both eyes of 50 obese young males and 50 healthy non-obese young males. The obese and the non-obese groups included subjects with a BMI of ⩾30 and ⩽25 kg/m², respectively. Subfoveal choroidal thickness and RNFL analyses were conducted by spectral domain optical coherence tomography (SD-OCT). Results: Subfoveal choroidal thickness (321.0 ± 46.7 vs 338.4±35.3, p = 0.002) and RNFL thickness at temporal quadrant (73.4 ± 9.9 vs 76.4 ± 9.3, p = 0.008) was significantly lower in the obese group when compared to the non-obese group. The groups did not differ regarding peripapillary RNFL thickness at other quadrants (superior, inferior, or nasal) or regarding mean peripapillary RNFL thickness. Conclusion: Findings of this study demonstrated a negative correlation of obesity with subfoveal choroidal thickness and temporal quadrant peripapillary RNFL thickness. Larger studies on different patient groups with longer-term follow-up are warranted to better elucidate the ophthalmological effects of obesity.


2018 ◽  
Vol 8 (2) ◽  
Author(s):  
Achmad Rifa’i ◽  
Handono Kalim ◽  
Kusworini Kusworini ◽  
Cesarius Singgih Wahono

Background : Low level of vitamin D impact the disease activity and the degree of fatigue in SLE patients. This study aims to determine the effect of vitamin D supplementation on disease activity and fatigue condition in Systemic Lupus Erythematosus (SLE) patients with hipovitamin D.Methods: We performed an open clinical trial. Subjects were randomized into two different groups (supplementation or placebo) using simple random sampling. The treatment group got vitamin D3 softgel/ cholecalciferol 1200 IU/day or 30 mg/day, while the control group gotplacebo for 3 months. SLEDAI scores and FSS scores were calculated at pre and posttreatment.Results: There were 20 subjectsfor supplementation group and 19 subjects in the placebo group. From this study, before and after treatment, we found a significant difference of mean level of vitamin D in supplementation group (p=0.000), and no significant difference inpatients with placebo (p=0.427). Moreover, from the SLEDAI score analysis, observed a significant difference bothin the supplemented group (p=0.000) and the placebo group (p=0.006). FSS scores significantly different in the supplemented group (p=0.000). Incorrelation test,there was a negative correlation (r=-0763) between vitamin D level and disease activity (SLEDAI), and both showing stastistical significance between thepre supplementation (p=0.000) and post supplementation (r=-0846; p=0.000). Similarly to theFSS scores, there was a meaningfulnegative correlation (r=-0.931, p=0.000) between the level of vitamin D with FSS scores pre and post supplementation (r=-0.911; p= 0.000). Furthermore, there was a significant correlation between disease activity (SLEDAI) pre supplementation with fatigue condition pre supplementation (r=0.846; p = 0.000) and postsupplementation (r=0.913; p= 0.000).Conclusion: The supplementation of vitamin D 1200 IU per day in patients with SLE improve disease activity and degree of fatigue. Keywords: vitamin D, disease activity, fatigue, SLE


2011 ◽  
Vol 38 (9) ◽  
pp. 1914-1919 ◽  
Author(s):  
LI-HSIN LIN ◽  
PIN LING ◽  
MING-FEI LIU

Objective.Type I interferons (IFN), especially IFN-α, have been proposed to underlie the pathogenesis of systemic lupus erythematosus (SLE). Members of the IFN regulatory factor (IRF) family, which regulate IFN expression, have been implicated as risk factors for SLE. Our aims were to investigate the expression of IRF7 and its correlation with disease activity and to explore the association in Taiwanese patients between 2 genetic single-nucleotide polymorphisms (SNP) of IRF7 and SLE.Methods.IRF7 messenger RNA (mRNA) levels were measured in peripheral blood mononuclear cells by real-time reverse transcription polymerase chain reaction in 51 adult patients with SLE and 65 age-matched and sex-matched controls. Their serum IFN-α levels were determined by ELISA and the clinical manifestations were recorded at the same time. Two IRF7 SNP, rs1061501 and rs1061502, were examined by genotyping across 92 patients with SLE and 92 age and sex-matched healthy control subjects.Results.Compared with controls, the expression of IRF7 mRNA was significantly increased in patients with SLE and was positively correlated with both the serum level of IFN-α and lupus disease activity. The distribution of SNP rs1061501 by genotype (CC, CT, and TT) and by allele (C, T) was significantly different between the SLE and the control group (p = 0.028 for genotype and p = 0.009 for allele). There were no significant differences for SNP rs1061502.Conclusion.The results suggest that dysregulation of IRF7 might mediate an excessive production of IFN-α, which then exerts a crucial effect on the pathogenesis of human SLE. The IRF7 SNP rs1061501 TT genotype and T allele are enriched in Taiwanese patients with SLE and thus would seem to be associated with an increased risk of developing SLE.


2001 ◽  
Vol 10 (4) ◽  
pp. 179-189 ◽  
Author(s):  
Ewa Robak ◽  
Hanna Niewiadomska ◽  
Tadeusz Robak ◽  
Jacek Bartkowiak ◽  
Jerzy Z. Bloński ◽  
...  

Human Tγσ lymphocytes constitute from 1 to 15% of all peripheral blood lymphocytes. Recent work has demonstrated that this population plays a major role in the pathogenesis of infectious and immune diseases. Increased numbers of γσ T cells have been found in affected skin from systemic sclerosis and chronic cutaneous lupus erythematosus patients.In our study, we have determined the numbers of Tγσ lymphocytes and their subpopulations in peripheral blood from 29 patients with systemic lupus erythematosus (SLE) and in 19 healthy volunteers using flow cytometry and specific monoclonal antibodies. The same cells in uninvolved skin from SLE patients and human controls using immunohistochemical analysis were estimated. T-Cell receptor (TCR) delta chain gene rearrangement was identified with primers for Vσ1, Vσ2 and Vσ3 by the polymerase chain reaction. Statistical analysis showed a significantly decreased number of γσ T cells in SLE patients (26.4 Ī 16.9/μl) compared with the control group (55.3 Ī 20.6/μl) (p<0.001). The number of Vσ2 TCR+ and Vγ9 TCR+ subpopulations was also lower in SLE patients than in healthy persons. No statistical correlation between disease activity and the number of γσ T cells was demonstrated. The percentage of T γσ lymphocytes in clinically normal skin from SLE patients was twice (22.0 Ī 9.4%) that found in the skin from healthy persons (11.1 Ī 5.5%) (p<0.002). Higher percentages of the Vσ2 TCR+ and Vγ9 TCR+ subpopulation of lymphocytes were found in the skin from SLE patients. We have also found positive correlation between the percentage of Tγσ lymphocytes in skin and the activity of SLE (r=0.594, p<0.001), and between subpopulation Vσ3 TCR+ and disease activity (r=0.659, p<0.001). In conclusion, the results of our studies demonstrate that, in patients with SLE, accumulation of Tγσ lymphocytes can be seen in clinically normal skin, and the percentage of these cells correlates with the activity of the disease.


Lupus ◽  
2016 ◽  
Vol 26 (2) ◽  
pp. 132-138 ◽  
Author(s):  
Y H Lee ◽  
G G Song

Objective This study aimed to systemically review the evidence regarding the relationship between circulating blood osteopontin (OPN) level and systemic lupus erythematosus (SLE), correlation between serum OPN levels and SLE activity, and association between OPN polymorphisms and SLE susceptibility. Methods We conducted a meta-analysis on the serum/plasma OPN levels in SLE patients and healthy controls, correlation coefficients between the circulating OPN level and SLE Disease Activity Index (SLEDAI) in SLE patients, and the association between OPN polymorphisms and SLE risk. Results Nine studies with 1938 SLE patients and 3037 controls were included. Meta-analysis revealed that, compared with the control group, the OPN level was significantly higher in the SLE group (SMD = 0.965, 95% CI = 0.337–1.393, p = 0.001) and in the SLE group with renal disease (SMD = 2.219, 95% CI = 0.681–3.757, p = 0.005). Meta-analysis of correlation coefficients showed a trend of positive correlation between the circulating OPN level and SLEDAI (correlation coefficient = 0.590, 95% CI = −0.025 to 0.881, p = 0.059). While no association was found between SLE and the OPN 707 T/C and 1083 G/A polymorphisms, a significant association was identified between the OPN 1239 C allele and SLE (OR = 1.192, 95% CI = 1.008–1.410, p = 0.040), and between the OPN 9250 C allele and SLE in Asians (OR = 2.070, 95% CI = 1.570–2.730, p = 2.5 × 10−7). Conclusions Our meta-analysis revealed a significantly higher circulating OPN level in SLE patients, a trend of positive correlation between OPN levels and SLE activity, and a significant association between OPN 1239 C/A and 9250 C/T polymorphisms, and SLE development.


2021 ◽  
Author(s):  
Wei Quan ◽  
Jingnan An ◽  
Gang Li ◽  
Guanghui Qian ◽  
Meifang Jin ◽  
...  

Abstract Background: Childhood-onset systemic lupus erythematosus (cSLE) is a kind of chronic inflammatory disease characterized by a highly abnormal immune system. This study aimed to detect expression of the Th cytokines IL-2, IL-4, IL-5, IL-6, IL-9, IL-10, IL-13, IL-17A, IL-17F, IL-21, IL-22, IFN-γ and TNF-α in the peripheral blood of children with cSLE; clinical symptoms; and a disease index and discuss the relationship between the Th cell cytokine regulatory network and onset of systemic lupus erythematosus (SLE) in children and disease outcome.Methods: A total of 33 children with cSLE and 30 healthy children were enrolled in this study. Children in the cSLE group were classified into the inactive cSLE group or active cSLE group according to their SLE disease activity index 2000 (SLEDAI-2K). Th cytokine profiles in peripheral blood of different groups were detected and analyzed.Results: The levels of IL-2, IL-10 and IL-21 in the cSLE group were significantly higher than those in the healthy control group (P < 0.05, P<0.01 and P<0.01, respectively). The expression of IL-2, IL-10 and IL-21 in the active cSLE group was significantly higher than that in the healthy control group (P<0.05, P<0.01 and P<0.05, respectively), but IL-22 expression was remarkably lower in the active cSLE group than in the healthy control group (P<0.001). IL-21 in the inactive SLE group was significantly higher than that in the healthy control group (P<0.05). The levels of IL-2 and IL-10 in the active cSLE group were significantly higher than those in the inactive cSLE group (P<0.01 and P<0.05). In-depth analysis showed that the expression levels of IL-2 (r=0.382, P=0.028), IL-6 (r=0.514, P=0.002) and IL-10 (r=0.429, P=0.016) were positively correlated with disease activity. Conclusion: This study provides a theoretical basis for the discovery of effective methods to regulate imbalance in T lymphocyte subsets in cSLE, which may open up potential new approaches for the diagnosis of cSLE.


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