Retinopathy in newly-diagnosed systemic lupus erythematosus: should we screen for ocular involvement?

Disease activity Ocular manifestations Retinopathy Systemic lupus erythematosus Vasculopathy

Journal

BMC rheumatology
ISSN: 2520-1026
Titre abrégé: BMC Rheumatol
Pays: England
ID NLM: 101738571

Informations de publication

Date de publication:
01 Oct 2021
Historique:
received: 09 03 2021
accepted: 12 05 2021
entrez: 1 10 2021
pubmed: 2 10 2021
medline: 2 10 2021
Statut: epublish

Résumé

Ocular manifestations are common in systemic lupus erythematosus (SLE). Retinopathy has previously been linked to disease severity and might have a significant impact on the patient's quality of life and has also been associated with a poor prognosis in SLE. This study aimed to determine the prevalence of retinopathy among patients who are newly diagnosed with SLE. In a cross-sectional study, patients diagnosed with SLE at a tertiary referral clinic were assessed for inclusion between March 2016 and March 2017. Patients who had received treatment for SLE at any time were excluded, as well as patients with hypertension, diabetes mellitus, and coagulopathy. Clinical findings and laboratory test results were recorded, and patients were examined by an ophthalmologist for evidence of retinal pathologies. SLE disease activity index was also calculated for all patients. With 114 patients included in the final analysis, we found a prevalence of 15.8% for retinopathy among newly-diagnosed SLE patients. Cotton-wool spots were the most common finding (78%). Patients with retinopathy had significantly lower hemoglobin levels, C3 and C4 concentrations, and higher ANA and Anti-dsDNA levels. Also, patients with retinopathy had a significantly higher SLE DAI score. We found a relatively high rate of retinopathy in SLE patients at the time of their initial diagnosis. Our findings suggest that retinopathy is an early manifestation of the disease. Ophthalmologic screening might be considered for SLE patients at the time of diagnosis, especially for those with severe disease. We also encourage researchers to further evaluate the correlation between retinopathy and disease activity, and the prognosis of ocular involvement.

Sections du résumé

BACKGROUND BACKGROUND
Ocular manifestations are common in systemic lupus erythematosus (SLE). Retinopathy has previously been linked to disease severity and might have a significant impact on the patient's quality of life and has also been associated with a poor prognosis in SLE. This study aimed to determine the prevalence of retinopathy among patients who are newly diagnosed with SLE.
METHODS METHODS
In a cross-sectional study, patients diagnosed with SLE at a tertiary referral clinic were assessed for inclusion between March 2016 and March 2017. Patients who had received treatment for SLE at any time were excluded, as well as patients with hypertension, diabetes mellitus, and coagulopathy. Clinical findings and laboratory test results were recorded, and patients were examined by an ophthalmologist for evidence of retinal pathologies. SLE disease activity index was also calculated for all patients.
RESULTS RESULTS
With 114 patients included in the final analysis, we found a prevalence of 15.8% for retinopathy among newly-diagnosed SLE patients. Cotton-wool spots were the most common finding (78%). Patients with retinopathy had significantly lower hemoglobin levels, C3 and C4 concentrations, and higher ANA and Anti-dsDNA levels. Also, patients with retinopathy had a significantly higher SLE DAI score.
CONCLUSIONS CONCLUSIONS
We found a relatively high rate of retinopathy in SLE patients at the time of their initial diagnosis. Our findings suggest that retinopathy is an early manifestation of the disease. Ophthalmologic screening might be considered for SLE patients at the time of diagnosis, especially for those with severe disease. We also encourage researchers to further evaluate the correlation between retinopathy and disease activity, and the prognosis of ocular involvement.

Identifiants

pubmed: 34593048
doi: 10.1186/s41927-021-00203-5
pii: 10.1186/s41927-021-00203-5
pmc: PMC8485475
doi:

Types de publication

Journal Article

Langues

eng

Pagination

34

Informations de copyright

© 2021. The Author(s).

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Auteurs

Hamidreza Bashiri (H)

Department of Internal Medicine, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Nooshin Karimi (N)

Rheumatology Research Center, Tehran University of Medical Sciences, North Amirabad street, Tehran, 1411713137, Iran.

Shayan Mostafaei (S)

Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Azarakhsh Baghdadi (A)

Rheumatology Research Center, Tehran University of Medical Sciences, North Amirabad street, Tehran, 1411713137, Iran. azarakhsh.baghdadi88@gmail.com.

Mohammad Nejadhosseinian (M)

Rheumatology Research Center, Tehran University of Medical Sciences, North Amirabad street, Tehran, 1411713137, Iran.

Seyedeh Tahereh Faezi (ST)

Rheumatology Research Center, Tehran University of Medical Sciences, North Amirabad street, Tehran, 1411713137, Iran. tfaezi@sina.tums.ac.ir.

Classifications MeSH